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OBJECTIVE: Diabetes mellitus (DM) is a common risk factor for stroke. Hence stroke awareness is very critical in diabetic patients. In order to design effective educational strategies for stroke intervention and prevention in this high risk group, we assessed the current status of knowledge about stroke symptoms, risk factors and activation of emergency medical services in individuals with DM. METHOD: A hospital-based survey was conducted between February and August 2011. Subjects who have DM were interviewed at 2 sites by trained Internal medicine, Neurology residents and medical students using a structured, closed-ended questionnaire. RESULTS: Two hundred and thirty subjects were interviewed, 64% female and 71% Caribbean-American and African-American. Seventy five percent of subjects had hypertension. Only sixty percent of subjects knew that they were high risk of stroke and only 46% had been informed by their primary care physician about this risk. More than 75% did not know their hemoglobin a1c and cholesterol levels. Stroke and diabetic ketoacidosis were the least recognized medical complications of DM (29%) while diabetic foot ulcer and diabetic nephropathy were the most recognized complications (54%). Hypertension was the most identified stroke risk factor (66%). Eighty-nine percent of respondents identified two or more stroke symptoms. Only 58% of respondents would call 911 for a stroke scenario. Subjects having DM > 10 years (p=0.02) and graduating from high school (p=0.002) were more likely to call 911, while people who had a history of kidney disease were less likely to call 911 (p=0.024). The two most common sources of information about stroke that DM patients received were from their primary care physicians (43%) and family and friends (35%). CONCLUSION: Stroke is one of the least recognized medical complications in DM patients. Primary care physicians play a very important role of stroke education in this high risk population.

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