Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care
Diabetes is a chronic condition that affects how your body processes blood sugar, and while it is widely known for its impact on the heart, kidneys, and eyes, its connection to stroke is often overlooked. Yet, people with diabetes are up to four times more likely to experience a stroke compared to those without the condition. Stroke, a sudden interruption of blood flow to the brain, is a leading cause of disability and one of the top causes of death worldwide. Understanding how diabetes increases the risk of stroke — and what steps can be taken to reduce that risk — is crucial for anyone managing this condition. In this article, we explore the link between diabetes and stroke, explain why the risk is higher, and outline practical ways to protect your brain and overall health.
How Diabetes Affects the Body and Increases Stroke Risk
Diabetes damages the body by causing high blood sugar levels, which harms blood vessels and nerves throughout the body and leads to an increased risk of stroke. People with diabetes are about twice as likely to have a stroke compared to those without diabetes.
How diabetes increases stroke risk
High blood sugar levels cause progressive damage that dramatically increases the risk of stroke in several ways:
- Hardening of the arteries (atherosclerosis): High glucose levels can accelerate the buildup of fatty deposits, known as plaque, on the inside of artery walls. If this occurs in the arteries supplying the brain, it can lead to an ischemic stroke, the most common type.
- High blood pressure (hypertension): A vast majority of people with diabetes also have high blood pressure, which is a leading cause of stroke. High blood pressure further stiffens and narrows blood vessels, increasing the risk of clots.
- Microvascular damage: Diabetes can damage the tiny blood vessels that supply oxygen to the brain, which can lead to a specific type of stroke called a lacunar infarction.
- Poor blood circulation: Nerve and circulation issues, particularly in the legs and feet, are common in people with diabetes. This can increase the likelihood of clots forming that could travel to the brain.
- Worse outcomes after a stroke: For those who experience a stroke, having diabetes is associated with poorer outcomes, including higher mortality rates, a greater risk of disability, and an increased risk of another stroke.
Understanding Stroke: Types and Symptoms
A stroke is a medical emergency that occurs when blood flow to the brain is interrupted, causing brain cells to die. There are three main types: ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA).
Ischemic stroke
This is the most common type of stroke, making up about 87% of all cases. It occurs when a blood vessel in the brain is blocked by a clot, which can be:
- Thrombotic: A clot forms in an artery supplying the brain.
- Embolic: A clot travels from another part of the body, often the heart, to the brain.
Key Warning Signs to Watch If You Have Diabetes
Key warning signs to watch for if you have diabetes include frequent urination, excessive thirst, increased hunger, extreme fatigue, blurry vision, slow healing of cuts or wounds, unexplained weight loss (especially in type 1 diabetes), and tingling or numbness in the hands or feet. Additional signs can be itchy, dry skin and patches of darker skin in body folds (acanthosis nigricans), as well as recurring infections such as yeast infections. These symptoms occur due to high blood sugar levels affecting various body functions and tissues, and early recognition is crucial to prevent serious complications like heart disease, kidney damage, nerve damage, and vision loss.
Common Key Warning Signs
- Frequent urination and increased thirst due to kidneys working overtime to get rid of excess sugar.
- Strong hunger despite eating due to glucose not entering cells for energy.
- Fatigue from lack of energy supply to body cells.
- Blurred vision due to changes in fluid levels affecting eye lenses.
- Slow-healing cuts and wounds because high sugar impairs immune function.
- Unexplained weight loss, mainly in type 1 diabetes.
- Tingling, numbness, or pain in hands and feet from nerve damage (neuropathy).
- Dry, itchy skin and recurring infections such as yeast infections.
Importance of Early Detection
Recognizing these signs early can lead to timely diagnosis and management, reducing the risk of severe complications including heart disease, stroke, amputations from chronic ulcers, kidney failure, and vision loss. People with risk factors like family history, obesity, or sedentary lifestyle should be especially vigilant and undergo regular screening even without obvious symptoms.
You may also like to read: Cardiometabolic Disease
Lifestyle and Medical Strategies to Reduce Stroke Risk
Medical and Lifestyle strategies to reduce stroke risk, especially for individuals with diabetes, include a combination of blood pressure control, healthy diet, regular physical activity, weight management, medication adherence, and management of other risk factors like cholesterol and blood sugar levels.
Lifestyle Strategies
- Reduced blood pressure: Maintain systolic blood pressure of 130 mmHg or less with toleration to minimize the risk of stroke.
- Diet: Healthy diet includes lots of fruits, vegetables, low saturated and trans-fat food, and low salt intake contribute to healthy blood pressure and cholesterol.
- Exercise: Moderate aerobic exercises 2.5 hours per week reduce cardiovascular health and insulin sensitivity.
- Weight loss: An excess weight, even small one, reduces risk factors such as hypertension and diabetes.
- Stop smoking and alcohol: Cessation of smoking and alcohol cut down on stroke risk substantially.
Medical Strategies
- Glycemic: Tight blood sugar regulation with drugs such as metformin, GLP-1 receptor agonists, or SGLT2 inhibitors decreases vascular complications.
- Medications: It is important to take antihypertensives when they are prescribed to sustain the target.
- Cholesterol: Statins decrease major cardiovascular events and LDL cholesterol.
- Antiplatelet treatment: Low-dose aspirin may prevent stroke in certain high-risk patients.
- Regular monitoring: Screen for diabetes, check cholesterol, and monitor blood pressure regularly.
Combining these strategies helps reduce inflammatory markers, improve insulin sensitivity, and lower overall cardiovascular risk, thus effectively lowering stroke risk in diabetic patients.
Final Thoughts
Diabetes and stroke go hand in hand yet the positive side is that most of the risks can be alleviated by awareness and preventive measures. With a healthy lifestyle, control of blood sugar, blood pressure, and cholesterol levels, and the close collaboration with medical professionals, people with diabetes can reduce their risk of having a stroke dramatically. Knowledge of this relationship is the initial step, what counts is action, which can save you and your long-term health.
FAQs
Can diabetes cause a stroke?
Diabetes is a risk factor that leads to stroke; stroke may destroy brain tissue and lead to disability or death. To avoid stroke, diabetics ought to control blood glucose, blood pressure, cholesterol and weight. The signs of stroke should be familiar to you and those who are close to you to access prompt medical care.
What is the survival rate for diabetic stroke victims?
Follow-up was done whereby 104 (72) patients experienced a vascular composite end point. Of these, 33 (32) had a repeat stroke, 33 (32) a hard cardiovascular event, and 76 (53) a cardiovascular or diabetes-related death, and the 1-year survival was 76 and 5-year survival was 58.
What is the most common life-threatening emergency in diabetes?
Diabetic ketoacidosis (DKA) is severe and may result in fatality. DKA occurs when there is a lack of insulin in your body to enable blood sugar into your cells to use as energy. DKA predominates in individuals with type 1 diabetes.