PATTERN OF STROKE IN PATIENTS WITH DIABETES MELLITUS PRESENTING TO TERTIARY CARE HOSPITAL

A KHAN; W KHAN; A JABBAR; A AHAD; MR ZIAULLAH; M SHAFIQ

doi:10.54112/pjicm.v5i01.63

Authors

A KHAN Department of General Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan
W KHAN Department of General Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan
A JABBAR Department of General Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan
A AHAD Department of General Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan
MR ZIAULLAH Department of General Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan
M SHAFIQ Department of General Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i01.63

Keywords:

Diabetes Mellitus, Stroke Pattern, Ischemic Stroke, Hemorrhagic Stroke, Hypertension, Tertiary Care

Abstract

Background: Stroke remains a leading cause of morbidity and mortality globally, with diabetes mellitus being a significant risk factor. Diabetic patients are predisposed to both ischemic and hemorrhagic stroke due to vascular complications. Understanding the stroke pattern in diabetic individuals is crucial for targeted prevention and management strategies. Objective: To assess the pattern of stroke—ischemic or hemorrhagic-in diabetic patients presenting to a tertiary care hospital. Study Design: Descriptive cross-sectional study. Setting: Department of Medicine, Saidu Teaching Hospital, Swat. Duration of Study: The study spanned a defined period (29-July-2023 to 29 January 2024). Methods: A total of 100 diabetic patients presenting with stroke were enrolled. Demographic data, including age, gender, and history of hypertension, were collected. Stroke type was confirmed using neuroimaging techniques such as CT or MRI. Statistical analysis was performed using SPSS version 24, with chi-square tests applied to assess the association between patient characteristics and stroke type. A p-value ≤ 0.05 was considered statistically significant. Results: The mean age of participants was 51.65 ± 13.56 years. A male predominance was noted (61%). Hypertension was present in 61% of patients. Ischemic stroke was more prevalent (87%) compared to hemorrhagic stroke (13%). A statistically significant association was found between increasing age and the type of stroke (p = 0.02). Conclusion: Ischemic stroke is significantly more common than hemorrhagic stroke among diabetic patients, accounting for 87% of cases. Age appears to be an essential factor influencing stroke type. These findings underscore the need for proactive screening and prevention of ischemic events in diabetic populations.

References

Cole JB, Florez JC. Genetics of diabetes mellitus and diabetes complications. Nat Rev Nephrol. 2020;16(7):377-90.

Ahmad E, Lim S, Lamptey R, Webb DR, Davies MJ. Type 2 diabetes. Lancet. 2022;400(10365):1803-20.

Suryasa IW, Rodríguez-Gámez M, Koldoris T. Health and treatment of diabetes mellitus. Int J Health Sci. 2021;5(1):572192.

Lovic D, Piperidou A, Zografou I, Grassos H, Pittaras A, Manolis A. The growing epidemic of diabetes mellitus. Curr Vasc Pharmacol. 2020;18(2):104-9.

Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913):245-55.

Beaglehole R, Bonita R, Alleyne G, et al. UN high-level meeting on non-communicable diseases: addressing four questions. Lancet 2011; 378(9789): 449-55.

Feigin VL, Mensah GA, Norrving B, et al. Atlas of the global burden of stroke (1990-2013): the GBD 2013 study. Neuroepidemiology 2015; 45:230–236.

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, De Ferranti S, Després JP, Fullerton HJ, Howard VJ. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38-60.

Jauch EC, Saver JL, Adams HP, Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013;44(3):870–947.

Feigin VL, Lawes CMM, Bennett DA, et al. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 2009; 8(4):355–69.

Owolabi MO, Sarfo F, Akinyemi R, et al. Dominant modifiable risk factors for stroke in Ghana and Nigeria (SIREN): a case-control study. Lancet Glob Health 2018;6(4):e436–e446.

Boehme AK, Esenwa C, Elkind MSV. Stroke risk factors, genetics, and prevention. Circ Res 2017;120(3):472-95.

Ali R, Kazmi S, Iqbal MZ. Pattern of stroke in diabetics and non-diabetics. J Ayub Med. 2013;25(1-2):89-92.

Karapanayiotides T, Piechowski-Jozwiak B, Van Melle G, Bogousslavsky J, Devuyst G. Stroke patterns, etiology, and prognosis in patients with diabetes mellitus. Neurology. 2004;62:1558–1562.

Zafar A, Shahid SK, Siddiqui M, Khan FS. Pattern of stroke in type 2 diabetic subjects versus non diabetic subjects. J Ayub Med Coll Abbottabad. 2007;19(4):64–67.

Siddiqui SA, Ahmed M, Haq A, Ahmed A, Qureshi PA. Pattern of Stroke in Diabetic and Non-Diabetic Patients Admitted at a Tertiary Care Hospital, a Cross Sectional Study. J. of Clin Case Rep and Stu. 2021;2(5).