Diabetes is a health condition where the blood sugar level rises due to pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced.
There are several pathophysiological mechanisms wherein ischemic stroke including large artery atherosclerosis, cerebral SVD and cardiac embolism. The presence of diabetes is associated with an increased risk of stroke but also post-stroke outcomes are generally worse in people with diabetes than in those without diabetes.
However, high blood sugar stiffens the blood vessels which over time leads to fatty deposits or clots in the blood vessels. The clots narrow down the blood vessels and cut off blood supply to main organs like the brain and hence cause stroke.
Diabetes is often associated with cardiometabolic risk factors that increases the risk of suffering from stroke. The post-stroke condition worsens in people with diabetes and there is a greater risk for the recurrence of stroke.
Currently, 537 million adults are suffering from diabetes and is associated with a higher risk of hemorrhagic stroke and ischemic stroke. The risk of suffering from ischemic stroke increases by 3% each year and triples in those with diabetes for more than 10 years compared to those without diabetes.
Diabetes plays an active role in influencing three common causes of stroke including large artery atherosclerosis, cerebral small vessel disease (SVD), and cardiac embolism. Large artery atherosclerosis, a leading cause of stroke is affected by the physiological changes caused due to dyslipidemia, hyperglycemia and insulin resistance. Cerebral microvascular dysfunction is commonly seen in people with diabetes which makes people prone to lacunar and hemorrhagic strokes. People with diabetes have 35% higher risk of atrial fibrillation, which is a potential cause of cardiometabolic stroke.
It is important to maintain a healthy lifestyle by maintaining the blood pressure level, reducing the bad cholesterol with healthy eating, physical activity and medicine. It is also essential for the diabetic to avoid smoking.
Apart from diabetes, the other risk factors for stroke are overweight, high blood pressure, high cholesterol and tobacco consumption.