• Rashid Ali
  • Sumera Kazmi
  • Muhammad Zafar Iqbal


Background: Diabetes mellitus has been established as a risk factor for stroke. Diabetes increases the risk of stroke in younger patients and diabetics aremore likely to have an ischemic stroke. There are numerous studies on microvascular complications but there are only a few studies on strokes in diabetics. Therefore, this study was conducted to assess the impact of diabetes on the pattern of stroke in our population. Methods: This descriptive study was carried out in Department of Medicine, Ayub Teaching Hospital, Abbottabad from September 2011 to February 2012. Forty diabetics and 40 non-diabetics stroke patients were included in the study. Risk factors were noted and their distribution in both groups was analysed. Results: The difference in age and gender distribution in both groups was not significant. Thirty-four (85%) of diabetics, and 25 (62.5%) non-diabetics suffered from ischemic stroke. Six (15%) of diabetics and 15 (37.5%) of non-diabetics suffered from haemorrhagic stroke. The differences between the distribution of ischemic stroke were significant (p<0.02). In the diabetic group 32.5% of the individuals suffered from lacunar infarcts and in the non-diabetic group 10% suffered from lacunar infarctions (p<0.02). There was no significant difference in distribution of risk factors. Conclusion: Diabetics are more likely to have an ischemic stroke and lacunar infarctions.Keywords: Diabetes mellitus, Stroke, Lacunar infarcts


Wild S, Roglic G, Greens A, Sicree R, King H. Global Prevalence of Diabetes. Diabetes Care 2004;27:1047–53.

American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care 2008;31:596–615.

Kothari V, Stevens RJ, Adler AI, Stratton IM, Manley SE, Neil HA, et al. Risk of Stroke in Type 2 Diabetes estimated by the UK Prospective Diabetes Study Risk Engine UKPDS 60. Stroke 2002;33:1776–81.

Kissela BM, Khoury J, Kleindorfer D, Woo D, Schneider A, Alwell K, et al. Epidemiology of ischemic stroke in patients with diabetes: the greater Cincinnati/Northern Kentucky Stroke Study. Diabetes Care 2005;28:355–9.

Saunder D, Sander K, Poppet H. Stroke in Type 2 Diabetes. Br J Diabetes Vasc Dis 2008;8:222–9.

Mulnier HE, Seaman HE, Raleigh VS, Soedamah-Muthu SS, Colhoun HM, Lawrenson RA, et al. Risk of stroke in people with Type 2 Diabetes in the UK: A study using the General Practice Research Database. Diabetologia 2006;49:2859–65.

Megherbi S-E, Milan C, Minier D, Couvreur G, Osseby G-V, Tilling K, et al. Association between diabetes and stroke subtypes on survival and functional outcome 3 months after stroke. Data from the European BIOMED Stroke Project. Stroke 2008;34:688–94.

Jorquensen H, Nakayama H, Raaschou HO, Olsen TS. Stroke in patients with Diabetes. The Copenhagen Stroke Study. Stroke 1994;25:1977–84.

Tuttolomondo A, Pinto A, Salemi G, Di-Raimondo D, Di-Sciacca R, Fernandez P, et al. Diabetic and non-diabetic subjects with ischemic stroke: differences, subtype, distribution and outcome. Nutr Metab Cardiovasc Dis 2008;18:152–7.

Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Burvill PW, Anderson CS, et al. Long-term risk of first recurrent stroke in the Perth Community Stroke Study. Stroke 1998;29:2491–500.

Karapanayiotides T, Piechowski-Jozwiak B, Metle GV, Bogousslavasky J, Devuyst G. Stroke patterns, etiology, and prognosis in patients with diabetes mellitus. Neurology 2004;62:1558–62.

Sarkar RN, Banerjee S, Basu. A Comparative evaluation of diabetic and non-diabetic stroke-effect of glycemia on outcome. J Indian Med Assoc 2004;102:551–3.

Zafar A, Shahid SK, Siddiqui M, Khan FS. Pattern of stroke in type 2 diabetic subjects versus non diabetic subjects. J Ayub Med Coll Abbottabad 2007;19:64–7.

Ho JE, Paultre F, Mosca L; Women’s Pooling Project. Is diabetes mellitus a cardiovascular disease risk equivalent for fatal stroke in women? Data from the Women’s Pooling Project. Stroke 2003;34:2812–6.

Farooq MU, Majid A, Reeves MJ, Birbeck GL. The epidemiology of stroke in Pakistan: past, present, and future. Int J Stroke 2009;4:381–9.

Folsom AR, Rasmussen ML, Chambless LE, Howard G, Cooper LS, Schmidt MI, et al. Prospective associations of fasting insulin, body fat distribution, and diabetes with risk of ischemic stroke. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. Diabetes Care 1999;22:1077–83.

Mast H, Thompson JL, Lee SH, Mohr JP, Sacco RL. Hypertension and diabetes mellitus as determinants of multiple lacunar infarcts. Stroke 1995;26:30–3.

Arboix A, Rivas A, Garcia-Eroles L, de Marcos L, Massons J, Oliveres M. Cerebral infarction in diabetes: clinical pattern, stroke subtypes, and predictors of in-hospital mortality. BMC Neurol 2005;5:9.

Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87:4–14.

King H, Aubert RE, Herman WH. Global burden of Diabetes, 1995–2025: Prevalence, Numerical estimates, and Projections. Diabetes Care 1998;21:1414–31.

21Bosch J, Yusuf S, Poque J, Sleight P, Lonn E, Rangoonwala B, et al; HOPE Investigators. Use of ramipril in preventing stroke: double blind randomized trial. BMJ 2002;324:699–702.

Hyvärinen M, Qiao Q, Tuomilehto J, Laatikainen T, Heine RJ, Stehouwer CD, et al. Hyperglycemia and stroke mortality: comparison between fasting and 2-h glucose criteria. Diabetes Care 2009;32:348–54.

Arboix A, Marti-Vilalta JL. Lacunar stroke. Expert Rev Neurother 2009;9:179–96.

Pyorala K, Pedersen TR, Kjekshus J, Faergeman O, Olsson AG, Thorgeirsson G. Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care 1997;20:614–20.

Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321(7258):405–12.

Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000;321(7258):412–9.




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