Diabetes and stroke

Diabetes is a recognized risk factor for stroke. This review summarizes recent studies detailing this risk. Recent reports have found that the risk appears significantly higher with type 1 than type 2 diabetes. Risk was assessed in various ethnic subgroups, and diabetes is at least as important a risk factor for stroke in blacks, South Asians, and Native Americans as it is in whites. Concomitant vascular risk factors and markers of diabetes severity (microalbuminuria, glycemic control) modify the association between diabetes and stroke risk. Several large studies have reinforced the association of prediabetic states, including the metabolic syndrome, with stroke risk in nondiabetics. Moreover, components of the metabolic syndrome increase stroke risk in diabetics. Diabetes adversely affects survival and cognitive and disability outcomes following stroke. Statins, oral hypoglycemics, and peroxisome proliferatoractivated receptor-γ inhibitors may be beneficial in preventing stroke or attenuating its adverse impact in this vulnerable population.