Diabetes mellitus and stroke: A clinical update

Abstract

Cardiovascular disease including stroke is a major complication that tremendously increases the morbidity and mortality in patients with diabetes mellitus (DM). DM poses about four times higher risk for stroke. Cardiometabolic risk factors including obesity, hypertension, and dyslipidaemia often co-exist in patients with DM that add on to stroke risk. Because of the strong association between DM and other stroke risk factors, physicians and diabetologists managing patients should have thorough understanding of these risk factors and management. This review is an evidence-based approach to the epidemiological aspects, pathophysiology, diagnostic work up and management algorithms for patients with diabetes and stroke.

Keywords: Diabetes mellitus; Stroke; Metabolic memory; Cardiovascular disease; Glycaemic management

Core tip: With the current global prevalence of more than 415 million, diabetes mellitus (DM) poses very high risk for cardiovascular diseases including stroke. Associated risk factors for stroke such as obesity, hypertension and dyslipidaemia are also high among DM cases especially in those with type 2 diabetes that further increases stroke risk. Thorough understanding of the epidemiology, pathophysiology and management options for patients with DM and co-morbidities is imperative for a rational medical practice among healthcare professionals. This review updates a scientific approach to patients with diabetes and stroke.