Multiple studies say diabetes puts you at risk of conditions such as heart disease, stroke, and kidney failure, but a healthy lifestyle and insulin treatments can help keep your risk low.
"Diabetes is well-recognized as a very significant risk factor in stroke risk, outcomes, and recurrence," says Timothy Petersen, an endocrinologist with Tidewater Physicians Multispecialty Group (TPMG), which provides specialty call coverage services to Sentara hospitals in coastal Virginia.
"The biggest relationship between diabetes and stroke is high blood sugar, and all the things that cause high sugar cause the blood vessels to be dysfunctional and often lead to problems with plaque buildup."
What Is a Stroke?
In a stroke, one of the many blood vessels that supply your brain with oxygen becomes damaged or blocked. If the blood flow is cut off for more than three to four minutes, that part of your brain begins to die.
There are two types of strokes:
- Hemorrhagic strokes: Caused by a ruptured artery
- Ischemic strokes: Result from a blocked artery
Diabetes can also make it harder for your body to respond to a stroke. When your oxygen supply is cut off, other arteries can usually serve as a bypass. But if you have diabetes, those vessels may be hardened or clogged with plaque, a condition known as atherosclerosis. This makes it harder for blood to get to your brain.
Can Diabetes Cause a Stroke?
High blood pressure is the leading risk factor for stroke. Others include smoking cigarettes and high levels of LDL ("bad") cholesterol.
Diabetes can also raise your chances of a stroke. Over time, high blood sugar levels can damage your blood vessels, which may lead to a blood clot. A blood clot that travels to your brain can cause a stroke.
Diabetes-Related Stroke Symptoms
A stroke is an emergency — whether you have diabetes or not. If you or someone near you has any of these symptoms, call 911 at once.
- Sudden numbness or weakness in the face, arm, or leg (especially on one side of the body)
- Trouble speaking or understanding words or simple sentences
- Sudden blurred vision or worse vision in one or both eyes
- Sudden trouble swallowing
- Dizziness, loss of balance, or lack of coordination
- Brief loss of consciousness
- Sudden inability to move part of the body (paralysis)
- Sudden, intense headache that can't be explained
How Is a Diabetes-Related Stroke Diagnosed?
These are some of the tests that your doctor may use to diagnose a diabetes-related stroke:
- Physical exams to see if you can move your arms, legs, and the muscles of your face
- Question and answer tests, or tests that ask you to describe a picture or object, to figure out how well your brain is working
- Imaging tests such as an MRI or CT scan
- Other tests that look at your heart or blood vessels
Diabetes-Related Stroke Treatment
One treatment for ischemic stroke is a clot-buster drug called tPA. This drug must be taken within four and a half hours after stroke symptoms begin. It dissolves the clot that has clogged an artery and can restore blood flow to the brain. But this drug isn't for all people who have an ischemic stroke, especially if you've had major surgery in the previous two weeks or recent head trauma.
Also, several new and experimental drugs may stop and even reverse brain damage if taken immediately after a stroke.
Other treatment options include a surgery called carotid endarterectomy to remove plaque from inside your carotid artery, which supplies much of the blood to your brain. Another treatment is known as carotid angioplasty and stenting. Doctors insert a deflated balloon into the artery to expand its walls. They follow it with a mesh structure, the stent, which holds the artery open. This procedure may not be as effective, especially if you have diabetes.
There are other ways to remove a blood clot in the brain. The FDA has approved several stent retrieval systems. These include the first-generation Merci Retriever and Penumbra System devices, the second-generation Solitaire Flow Restoration Device and Trevo Retriever, and the third-generation Tigertriever. These devices can remove a blood clot from your brain after a stroke.
How to Help Prevent Stroke
Petersen says addressing other health conditions related to diabetes can lower your chances of having a stroke. "Most patients with type 2 diabetes also end up having problems with blood pressure and blood cholesterol. And the combination of those factors, especially if you add in things like smoking, can lead to problems like a high risk of stroke, heart attack, and heart failure. So, we generally try to help with all of those conditions."
If you have diabetes and your doctor suspects your arteries are hardened, they may suggest diet and lifestyle changes — along with medicines — to prevent the blockages that lead to stroke. You can also lower your odds of a stroke by making these healthy choices:
- Don't smoke.
- Control your blood sugar level.
- Stay at a healthy weight.
- Exercise regularly.
- Get your cholesterol checked (especially your LDL, or "bad," cholesterol). The target should be an LDL level of less than 70 milligrams/deciliter (mg/dL). Your doctor may suggest changes to your diet or a medication to help get the numbers down.
- Limit the amount of alcohol you drink. The guidelines are no more than one drink per day for women and two drinks a day for men.
- Have your blood pressure checked. Your doctor will tell you how to get it under control if it's high.
- Take preventive medicines if prescribed by your doctor.
- Take daily aspirin if prescribed by your doctor. Some people with diabetes can benefit from low doses of aspirin (81-325 milligrams a day) to prevent heart disease.
Takeaways
Living with diabetes can mean a higher risk of stroke, which is when blood vessels supplying oxygen to your brain become damaged or blocked. High blood sugar from diabetes can damage these vessels, causing a blood clot and stroke. If you have diabetes, you can help avoid a stroke with diet and lifestyle changes and medicine to stop blockages that cause stroke.
Diabetes and Stroke FAQs
What is the survival rate for a person who has had a diabetes-related stroke?
People with diabetes who have a stroke may not live as long as those without diabetes who have a stroke. One study found that after five years, about 49% of people with diabetes were still alive, compared to about 55% of people without diabetes.
Can you recover from a stroke caused by diabetes?
Yes, but it depends on how serious the stroke was. Some people have a small stroke and feel better quickly. Others have a more serious stroke and need a lot of help to recover, such as going to a rehab center or staying in the hospital for a while. Recovery can take weeks, months, or even years, and some people may have long-term problems.
How are diabetes and stroke related?
When you have diabetes, your body can't use glucose (sugar) the right way. This causes glucose to build up in your blood, and over time, damages your blood vessels and raises your chances of having a stroke.
People with diabetes may also have other health problems, such as being overweight, high blood pressure, high cholesterol, or heart disease, which also make stroke more likely.
Can high blood sugar contribute to a stroke?
Diabetes means there is too much sugar (called glucose) in your blood. This can damage your blood vessels and raise your risk of having a stroke. When your blood sugar stays high for a long time, it can also stiffen your blood vessels and cause fat to build up in them.
Is there a blood sugar level that can cause a stroke?
There's not a specific blood sugar level that causes stroke, but having higher than normal blood sugar over a period of time can make a stroke more likely. A fasting blood sugar level of 126 milligrams per deciliter or higher on two different days is associated with a diagnosis of diabetes.
