The effects of micro- and macrovascular diabetic complications on ischemic stroke in patients with type 2 diabetes mellitus

Abstract

Objectives: The present study aimed to examine the effects of diabetes complications on the ischemic stroke risk among patients with type 2 diabetes mellitus (T2DM).

Patients and methods: The medical records of all patients (n=5,468) who were admitted to a tertiary care hospital between January 1, 2021, and June 1, 2022, were retrospectively reviewed. Of 911 patients diagnosed with T2DM for at least two years, 37 patients with a history of hemorrhagic cerebrovascular disease were excluded. Consequently, the study was conducted with 874 patients (460 males, 414 females; mean age: 65.5±12.1 years; range, 39 to 92 years) with T2DM. Demographic data, presence of chronic disease other than diabetes, duration of diabetes, retinopathy, nephropathy, peripheral arterial disease, and diabetes medications were recorded. The patients were divided into two groups: those with and without a history of ischemic stroke. The two groups were compared in terms of demographic characteristics and diabetes complications.

Results: The prevalence of ischemic stroke was 18.6% (n=163). Patients with ischemic stroke were older than those without ischemic stroke, had longer diabetes durations, and had higher rates of hypertension, hyperlipidemia, and insulin use (p=0.001, p<0.001, p<0.001, p<0.001, and p<0.001, respectively). Diabetic retinopathy (41.7%), diabetic nephropathy (27.6%), and peripheral arterial disease (16.6%) were more commonly observed among patients with ischemic stroke compared to the others. Examining the parameters differing between the groups, diabetes duration, hypertension, insulin use, and peripheral arterial disease were found to be independent risk factors for ischemic stroke (p<0.001, p<0.001, p=0.001, and p=0.001, respectively).

Conclusion: Examining the relationship between diabetes complications and ischemic stroke risk from a broader perspective, the present study provided important implications for clinical management. Large-scale studies are needed in the future.

Cite this article as: Zeytin Demiral G, Betaş Akın S. The effects of micro- and macrovascular diabetic complications on ischemic stroke in patients with type 2 diabetes mellitus. Turk J Neurol 2024;30(3):167-172. doi: 10.55697/tnd.2024.157.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

The study protocol was approved by the Afyonkarahisar University of Health Sciences Clinical Research Ethics Committee (date: 07.10.2022, no: 2022/467). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Patient data collection has been conducted retrospectively from records registered in the hospital. Therefore, informed consent has not been obtained through voluntary participation.

Study design, data analysis, interpretation of results, writing and revising the manuscript: G.Z.D.; Data collection, literature review, interpretation of results, writing and revising the manuscript: S.B.A.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.