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Diabetes and Stroke

Having diabetes ups your chances of having a stroke. Here's what you need to know, plus some steps you can take, to lower your risk.

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.

Types of Stroke

Ischemic stroke is usually caused by a blood clot and more common in people with diabetes; hemorrhagic stroke occurs when a weakened blood vessel ruptures.

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).

Risk Factors for Stroke

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. 

These include:

  • Obesity. A waist measurement of more than 40 inches for men or 35 for women indicates you are carrying too much central obesity. Abdominal fat can increase production of LDL (bad cholesterol) that gets deposited inside blood vessel walls.
  • High blood pressure. Hypertension, which makes the heart work harder to pump blood, can damage blood vessels and contribute to stroke.
  • Abnormal cholesterol levels. LDL cholesterol can build up in blood vessels causing them to narrow. High LDL cholesterol also contributes to the hardening of arteries.
  • Smoking. People who smoke are at double the risk of having a stroke as nonsmokers. Smoking irritates the lining of blood vessels and decreases the body’s ability to dissolve blood clots.
  • Drinking alcohol. Drinking more than 2 drinks a day for men and 1 for women may contribute to the risk of a stroke.

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.

Signs include:

  • Weakness or numbness of your face, arm, or leg on one side of your body.
  • Sudden confusion, difficulty talking or trouble understanding.
  • Sudden dizziness, loss of balance or trouble walking.
  • Sudden trouble seeing out of one or both eyes or sudden double vision.
  • Sudden, severe headache.

If you experience or think you’re experiencing any of these symptoms, call 911 right away.

Treatment

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.

Diabetes and Medications

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.

Updated on: March 25, 2016
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