Diabetic and non-diabetic subjects with ischemic stroke: Differences, subtype distribution and outcome

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RESEARCH PRODUCT

Diabetic and non-diabetic subjects with ischemic stroke: Differences, subtype distribution and outcome

Giuseppe Salemi Giuseppe Licata Giovanni Savettieri Antonino Tuttolomondo Paolo Ragonese Riccardo Di Sciacca Antonio Pinto Paola Fernandez Domenico Di Raimondo

subject

Male TOAST Classification Time Factors Settore MED/09 - Medicina Interna Endocrinology Diabetes and Metabolism Medicine (miscellaneous)Severity of Illness Index Brain Ischemia Recurrence Risk Factors Odds Ratio Prevalence Medicine Stroke Aged 80 and over Nutrition and Dietetics diabetes mellitu Middle Aged Prognosis Stroke Acute Disease Hypertension Cardiology Female Settore MED/26 - Neurologia Cardiology and Cardiovascular Medicine medicine.medical_specialty Lacunar stroke Risk Assessment Diabetes Complications TOAST classification Diabetes mellitus Internal medicine Severity of illness ischemic stroke Humans cardiovascular diseases Aged business.industry Case-control study Recovery of Function Odds ratio medicine.disease SSS*Logistic Models Diabetes Mellitus Type 2 Case-Control Studies Physical therapy Scandinavian Stroke Scale business Follow-Up Studies

description

Abstract Background and aim Diabetes mellitus increases the risk of stroke, and pathophysiological changes of diabetic cerebral vessels may differ in comparison with non-diabetic ones; nonetheless, the clinical and prognostic profile of stroke in diabetic patients is not yet fully understood. On this basis, the aim of our study was to evaluate cerebrovascular risk factor prevalence in diabetic stroke patients in comparison with non-diabetics, to analyze whether diabetics have a different prevalence of stroke subtypes as classified by the TOAST classification, and determine whether diabetics and non-diabetics have a different prognosis. Methods and results We enrolled 102 diabetics and 204 non-diabetic subjects with acute ischemic stroke, matched by sex and age (± 3 years). We used as outcome indicators the Scandinavian Stroke Scale (SSS) score at admission and the modified Rankin disability scale at discharge and at a 6-month follow-up. We classified ischemic stroke according to the TOAST classification. Diabetes was associated with lacunar ischemic stroke subtype, with a record of hypertension, and with a better SSS score at admission. The association of diabetes with lacunar stroke remained significant even after adjustment for hypertension or for large artery atherosclerotic and cardioembolic stroke subtypes. Conclusion Our study shows some significant differences in acute ischemic stroke among diabetics in comparison with non-diabetics (higher frequency of hypertension, higher prevalence of lacunar stroke subtype, lower neurological deficit at admission in diabetics).

year	journal	country	edition	language
2008-02-01

10.1016/j.numecd.2007.02.003 http://hdl.handle.net/10447/21817