Management of Macrovascular Disease in Diabetes (S Inzucchi and R Goldberg, Section Editors)

Current Diabetes Reports

, Volume 12, Issue 3, pp 314-323

The Diagnosis and Management of Cerebrovascular Disease in Diabetes

  • Michael S. PhippsAffiliated withVA Connecticut Healthcare SystemYale University School of Medicine Email author 
  • , Ania M. JastreboffAffiliated withYale University School of Medicine
  • , Karen FurieAffiliated withMassachusetts General Hospital, Harvard Medical School, J. Philip Kistler MGH Stroke Research Center
  • , Walter N. KernanAffiliated withYale University School of Medicine

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Abstract

Cerebrovascular disease is a leading cause of morbidity and mortality in diabetes. Compared with nondiabetic patients, diabetic patients have at least twice the risk for stroke, earlier onset of symptoms, and worse functional outcomes. Approximately 20 % of diabetic patients will die from stroke, making it one of the leading causes of death in this population. Effective strategies for primary and secondary prevention of stroke have been developed in research cohorts that included both diabetic and nondiabetic patients. Nevertheless, prevention in diabetes has some specific considerations. In this paper, we summarize evidence to guide the diagnosis and management of stroke in diabetic patients. We propose that diabetic stroke patients should have a robust risk assessment to target interventions, like other patients with cerebrovascular disease, but with special attention to glycemic control and lifestyle modification.

Keywords

Cerebrovascular disorders Stroke Cerebral hemorrhage Ischemic attack Transient Diabetes mellitus Diagnosis Therapeutics Cerebrovascular disease