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RESEARCH PRODUCT

Association between diabetes and stroke subtype on survival and functional outcome 3 months after stroke: data from the European BIOMED Stroke Project.

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To the Editor: Regarding the study by Megherbi et al1 performed to evaluate stroke features, prognosis, and functional outcome in patients with diabetes compared with patients without diabetes, we would like to discuss some issues of potential interest: First, the authors analyzed diabetic patients classified in accordance with WHO diagnostic criteria for diabetes used in 1993 (fasting plasma glucose >140 mg/dL), so it is probably an underestimation of the number of diabetic subjects in the 4537 consecutive patients with ischemic stroke enrolled. Perhaps if they could have classified diabetic patients in accordance with American Diabetes Association (1997)2 criteria (fasting plasma glucose >126 mg/dL), a higher number of diabetic subjects would have been detected. Indeed the authors do not distinguish among known diabetes, newly diagnosed diabetes, and stress response hyperglycemia. Second, in this study clinical subtypes of ischemic stroke were …