Strokes occur when the blood supply to the brain is suddenly interrupted, which can happen when a vessel in the brain or neck is blocked or bursts. Without adequate blood, brain cells are deprived of oxygen, which can lead to problems with vision or speech or can cause weakness or paralysis.
According to the American Diabetes Association, people with diabetes have a 1.5 times higher chance of having a stroke than someone without the disease.
Over time, high glucose levels can damage nerves and blood vessels, leading to complications including stroke and heart disease, the leading causes of death in people with diabetes.
There are two main types of stroke both of which can cause permanent brain damage. Ischemic stroke, is the most common and responsible for 87 percent of strokes. In an ischemic stroke the blood-flow to the brain is cut off by a blood clot or a fatty deposit. The clot—a jelly-like clump of blood cells—or deposit, narrow or block a blood vessel in the brain or neck. The clot may stay where it developed or travel within the body.
The second type is a hemorrhagic stroke, which occurs when a weakened blood vessel ruptures and spills blood into the surrounding brain tissue. Risk factors include high blood pressure or an aneurysm (a ballooning of a weakened artery).
People with diabetes are at increased risk for strokes caused by blood clots. But like heart disease, a stroke is not inevitable and can be prevented by staying alert to risk factors you may have in addition to diabetes. Keeping your blood glucose, blood pressure and blood cholesterol within target levels can reduce your chances of incurring a stroke.
Several risk factors play a role in causing a stroke including: being male, African-American, over 55, having a family history, or having had a prior TIA (transient ischemic attack) or mini-stroke. While these factors cannot be controlled, there are other risk factors that can be impacted by lifestyle changes.
Signs and Symptoms
Symptoms of a stroke can come on quickly and without warning. It’s urgent to receive medical attention immediately for any of these signs of stroke, since prompt treatment may prevent long-term brain damage.
If you experience or think you’re experiencing any of these symptoms, call 911 right away.
Getting to a hospital within an hour of a stroke can help to prevent permanent damage so it's imperative to take stroke signs seriously.
At the hospital, you may undergo a neurological test, special scans, blood tests, ultrasound examinations, or x-rays. Depending on the type of stroke, you may be given medication to dissolve blood clots.
In the case of ischemic stroke, patients may be given a clot-busting drug called tPA (tissue plasminogen activator), but the drug must be given within 3 hours of symptoms to prevent or minimize damage from the stroke. Blood vessel blockages can also be removed surgically, or a stent may be inserted to open a blocked blood vessel.
Medical personnel will work to stabilize and monitor a patient with hemorrhagic stroke. Medication to relieve swelling and pressure on the brain may be administered. To ease severe pressure, a tube may be inserted into the aneurysm.
Following a stroke, patients may be put on a special diet, encouraged to get more physical activity, and may be prescribed medications to lower blood glucose, blood pressure and cholesterol and to prevent blood clots.
Make sure your doctor knows about your diabetes, since some blood pressure lowering agents, including some beta-blockers and thiazide diuretics can impact blood glucose readings.
Beta-blockers, which work by blocking the hormone adrenaline, make the heart beat more slowly. A slower heart can mask the bodily symptoms of hypoglycemia, or low blood sugar, so it can be tougher to tell if you are experiencing this condition. If you are prone to low blood sugars, you will have to check your sugars regularly and eat on a consistent schedule.
Thiazide diuretics—which treat high blood pressure by blocking the reabsorption of sodium in the kidneys—may cause a small increase in blood glucose.