Clinical Characteristics and Outcomes of Acute Ischemic Stroke in Patients with Type 2 Diabetes: A Single-Center, Retrospective Study in Southern China

Abstract

Objective. To explore the associations between type 2 diabetes mellitus (DM) and stroke by evaluating the clinical risk factors, characteristics, and outcomes of acute ischemic stroke (AIS) patients with and without type 2 DM. Methods. A total of 1,156 AIS patients (including 410 with type 2 DM (AIS-DM group)) and 746 without type 2 DM (AIS-NDM group)) were included. Patients’ demographics, auxiliary examinations, clinical manifestations, and treatment outcomes were recorded and analyzed. Results. Among the included AIS patients, 35.46% had type 2 DM. The AIS-DM group had less males (59.76% versus 70.64%), less smokers (33.90% versus 41.96%), more patients with hypertension (72.93% versus 63.94%; p = 0.002 ), higher triglyceride levels (42.93% versus 25.08%; p ≤ 0.01 ), and lower total cholesterol (147.06 mg/dl versus 175.31 mg/dl) than the AIS-NDM group. The proportion of patients with large artery atherosclerosis (LAA) in the AIS-DM group was lower (77.56% versus 85.92%; p < 0.05 ) than that in the AIS-NDM group, and the proportion of patients with small arterial occlusions (SAO) in the AIS-DM group was higher (27.07% versus 13.67%; p < 0.05 ) than that in the AIS-NDM group. The mean National Institutes of Health Stroke Scale (NIHSS) score at admission in the AIS-DM group was lower than that in the AIS-NDM group (4.39 versus 5.00; p = 0.008 ), but there was no significant difference in the NIHSS score or the modified Rankin Scale score between the two groups at discharge. A total of 85 AIS patients underwent intravenous thrombolysis treatment with recombinant tissue plasminogen activator (rtPA). The door-to-needle time (DNT) did not differ significantly between the groups (49.39 ± 30.40 min versus 44.25 ± 15.24 min; p = 0.433 ). In addition, there were no significant differences in the baseline NIHSS score, 7-day NIHSS score, and mRS score at discharge between the groups. After intravenous thrombolysis with rtPA, the AIS-NDM group had better recovery (44.30% versus 29.20%; p = 0.017 ) and a higher ratio of good treatment outcome at discharge (65.60% versus 54.20%; p = 0.762 ). Conclusions. Type 2 DM is associated with AIS and its risk factors, such as dyslipidemia and hypertension. Patients in the AIS-DM group had less LAA and smaller arterial occlusions, and DM could exacerbate the short-term clinical outcomes in AIS patients.

Burden of Comorbidities Among Older Malaysians With Stroke: Associations With Diabetes Mellitus and Frailty

“…As such, the results of our analysis provide an evidence base for the older old population with participants in similar studies having a mean age ranging from 57-68 years. 4,[28][29][30][31][32] Analysis from the National Neurology Registry for Acute Stroke in Malaysia showed estimates of diabetes prevalence ranged from 24.9-53.3%…”

“…4,28,29 Similar studies in other countries such as Ethiopia, Pakistan and China have also reported a prevalence ranging from 8.1-35.46%. [30][31][32] In a study of 208 stroke patients in a hospital in the city of Yogyakarta, Indonesia, the prevalence of diabetes was found to be 34.1% with common comorbidities including hypertension, dyslipidaemia and cardiac diseases like atrial brillation. 4 In another analysis of 9766 patients across 3 hospitals in Singapore, the prevalence of diabetes in stroke inpatients was found to be 38.5%.…”

Burden of comorbidities among older Malaysians with stroke: Associations with diabetes mellitus and frailty

“…As such, the results of our analysis provide an evidence base for the older old population with participants in similar studies having a mean age ranging from 57-68 years. 4,[28][29][30][31][32] Analysis from the National Neurology Registry for Acute Stroke in Malaysia showed estimates of diabetes prevalence ranged from 24.9-53.3% depending on rst or recurrent stroke across ischemic and haemorrhagic stroke. 33 Studies in neighbouring countries such as Thailand, Indonesia and Singapore have reported prevalence ranging from 17.1-38.5%.…”

Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy

“…Previous studies have suggested that DM substantially increases the risk for first ischemic stroke ( 4 – 6 ). In addition, DM is associated with increased mortality ( 7 ) and recurrence rate of ischemic stroke ( 8 – 10 ).…”