Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes

Am J Med Sci. 2016 Apr;351(4):380-6. doi: 10.1016/j.amjms.2016.01.011.


There has been a significant increase in obesity rates worldwide with the corresponding surge in diabetes. Diabetes causes various microvascular and macrovascular changes often culminating in major clinical complications, 1 of which, is stroke. Although gains have been made over the last 2 decades in reducing the burden of stroke, the recent rise in rates of diabetes threatens to reverse these advances. Of the several mechanistic stroke subtypes, individuals with diabetes are especially susceptible to the consequences of cerebral small vessel diseases. Hyperglycemia confers greater risk of stroke occurrence. This increased risk is often seen in individuals with diabetes and is associated with poorer clinical outcomes (including higher mortality), especially following ischemic stroke. Improving stroke outcomes in individuals with diabetes requires prompt and persistent implementation of evidence-based medical therapies as well as adoption of beneficial lifestyle practices.

Keywords: Diabetes; Hyperglycemia; Outcomes; Stroke; Stroke prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiovascular Agents / therapeutic use
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / physiopathology*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin Resistance / physiology
  • Risk Factors
  • Risk Reduction Behavior
  • Stroke / drug therapy
  • Stroke / epidemiology*
  • Stroke / physiopathology*
  • Treatment Outcome


  • Cardiovascular Agents
  • Hypoglycemic Agents