Risk factors, etiology and prognosis in patients with ischemic stroke and diabetes mellitus

Introduction. The objective of this work is to describe the clinical, etiological and prognostic differences in diabetic and non-diabetic patients presenting ischemic stroke. Materials and methods. We performed a retrospective review of all patients with ischemic stroke requiring admission to the Neurology Service at the University Hospital of Gran Canaria Dr. Negrin (Spain) during our study period (1 Jan, 2004 - 31 Dec, 2006). We collected demographic, clinical and prognostic variables. Results. A total of 633 patients were included, 256 (40.4%) were diabetic and 377 (59.6%) were nondiabetic. The group of diabetic patients presented a mean age of 69.2 <= 9.3 years (65.4 <= 13.9 years in non-diabetic). Mean made up 63.7% of the diabetic patients and women 36.3% (62.2% men and 37.8% women in non-diabetics). A total of 85.9% of diabetic patients presented arterial hypertension (62.9% in non-diabetics); 49.2% had previous hyperlipidemia (31% in non-diabetics); 22% had ischemic heart disease (12.7% in non-diabetics); and 8.6% had peripheral arteriopathy (4.8% in non-diabetics). In the group of diabetic patients, 25% presented atherothrombotic stroke (16.4% in non-diabetics); 20.3% were cardioembolic (24.4% in non-diabetics); 26.1% were lacunar (22% in non-diabetics); and 25.7% had undetermined origin (27.2% in non-diabetics). The modified Rankin Scale at discharge was +/- 65.3% of diabetic patients and 62.5% in non-diabetics. Conclusions. In our series, diabetic patients frequently present other conventional vascular risk factors and show a tendency to more atherothrombotic strokes. We have found no significant differences in relation to prognosis.