Key result
Type 2 diabetes mellitus was associated with a significantly higher four-week mortality rate following acute stroke compared to patients without diabetes (43.8% vs 30.5%, p=0.046).
Why the study?
Stroke and diabetes mellitus are prevalent, vascular risk factor-associated conditions, but the association of diabetes with acute stroke course and short-term outcomes required evaluation.
Does Type 2 Diabetes Mellitus worsen the course and short-term outcomes in patients with acute stroke?
Observational (n=210)
No
Does Type 2 Diabetes Mellitus worsen the course and short-term outcomes in patients with acute stroke?
Type 2 diabetes mellitus is associated with a heavier burden for acute stroke, including higher rates of ischemic stroke, recurrence, aspirin failure, severe disability, and 4-week mortality compared to patients without diabetes.
Answers are grounded in this paper and cite their sources.
Diabetes may worsen short-term stroke prognosis; hypothesis-generating and requires prospective validation before guiding care.
Introduction Stroke and diabetes mellitus (DM) are distinct conditions with many aspects in common. Both conditions are prevalent and associated with various vascular risk factors such as dyslipidemia and hypertension. This study was conducted to evaluate the association between stroke and DM regarding the course (i.e., type, recurrence, aspirin failure, and degree of disability) of stroke and short-term outcomes in patients with diabetes who suffer an acute stroke. Patients and methods We conducted a prospective observational study of 210 acute stroke patients admitted to the Neurology Unit of Al-Basrah Teaching Hospital in Basrah City in Southern Iraq from May 2014 to September 2015. Our study included 124 men (59%) and 86 (41%) women, and our study population had a mean age of 64 ± 11 years. The study participants were separated into two groups of 105 patients according to their diabetes status, and we evaluated each patient's type of stroke, recurrence, aspirin failure, and degree of neurological disability according to the National Institutes of Health stroke scale. We assessed short-term outcomes (i.e., four weeks' mortality) following acute stroke. Results Ischemic stroke was the primary stroke experienced by patients with diabetes (94.3%), which is highly significant and associated with an increased risk of previous recurrent ischemic stroke (55.2%; P=0.003, <0.001, respectively). We noted a higher rate of loss of antiplatelet activity from aspirin in patients with DM rather than those without DM (p<0.001), and we noted more severe disability in outcomes in patients with DM. In the group of stroke patients with diabetes, 46 patients (59%) died, while 32 patients (41%) without diabetes died (p=0.046). Conclusion DM is associated with a heavier burden for acute stroke along with poorer outcomes than patients without DM. Our findings suggest acute stroke in patients with diabetes may be considered a distinct entity separate from acute stroke in patients without diabetes. The treatment of acute stroke in patients with diabetes warrants further investigation.
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Altemimi et al. (2019) conducted an observational in Acute stroke (n=210). Type 2 Diabetes Mellitus vs. No Type 2 Diabetes Mellitus was evaluated on Four-week mortality (p=0.046). Type 2 diabetes mellitus was associated with a significantly higher four-week mortality rate following acute stroke compared to patients without diabetes (43.8% vs 30.5%, p=0.046).
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