COMPARISON OF CLINICAL MANIFESTATION AND RISK FACTORS OF STROKE AMONG DIABETIC VS NON-DIABETIC PATIENTS

M ILYAS; O ISMAIL; W ULLAH; F ULLAH; MIU HAQ; S AKBAR

doi:10.54112/pjicm.v5i01.89

Authors

M ILYAS Department of Internal Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan
O ISMAIL Lady Reading Hospital, Peshawar, Pakistan
W ULLAH Khalifa Gul Nawaz Teaching Hospital (MTI), Bannu, Pakistan
F ULLAH Department of Internal Medicine, Khyber Teaching Hospital (MTI) Peshawar, Pakistan.
MIU HAQ Department of Internal Medicine, Khyber Teaching Hospital (MTI) Peshawar, Pakistan.
S AKBAR THQ Hospital Kallurkot District Bhakkar, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i01.89

Keywords:

Stroke, Diabetes, Ischemic Stroke, Hemorrhagic Stroke, Risk Factors

Abstract

Background: Stroke is a leading cause of morbidity and mortality worldwide. Diabetes mellitus is a known risk factor that may influence both the presentation and progression of stroke. Understanding the differences in clinical manifestations and risk factors between diabetic and non-diabetic stroke patients is essential for tailored prevention and management strategies. Objective: To compare the clinical manifestations and associated risk factors of stroke among diabetic and non-diabetic patients. Study Design: Cross-sectional study. Setting: The study was conducted at the department of Medicine, Saidu Group of Teaching Hospital Swat, Pakistan]. Duration of Study: August 2024 to January 2025. Methods: The study included 80 patients aged 40 years and above who were diagnosed with stroke, confirmed by clinical examination and neuroimaging. Patients were categorized into two equal groups: diabetics (n = 40) and non-diabetics (n = 40). Data were collected on demographics, risk factors (hypertension, dyslipidemia, smoking, atrial fibrillation, and previous stroke history), and clinical manifestations (motor deficits, aphasia, dysarthria, and altered sensorium). Statistical analysis was conducted using Chi-square tests and independent t-tests, with a p-value <0.05 considered statistically significant. Results: The mean age of diabetic patients was 50.65 ± 7.49 years, while that of non-diabetics was 52.20 ± 6.09 years. Motor deficits were observed in 80% of diabetics and 75% of non-diabetics (p > 0.05). Dysarthria occurred in 55% vs 45% (p > 0.05), aphasia in 22.5% vs 25% (p > 0.05), and altered sensorium in 45% vs 32.5% (p > 0.05), respectively. Hypertension was significantly more prevalent in diabetics (62.5%) compared to non-diabetics (30%) (p = 0.004). Dyslipidemia was more common in diabetics (60%) than in non-diabetics (42.5%) (p > 0.05). Atrial fibrillation and previous stroke history did not differ significantly between groups. Conclusion: While clinical manifestations of stroke were similar between diabetic and non-diabetic patients, hypertension was significantly more prevalent in the diabetic group. These findings highlight the importance of strict blood pressure control in diabetic patients to prevent stroke-related complications.

References

Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88-98.

Carrillo-Larco RM, Barengo NC, Albitres-Flores L, Bernabe-Ortiz A. The risk of mortality among people with type 2 diabetes in Latin America: A systematic review and meta-analysis of population-based cohort studies. Diabetes Metab Res Rev. 2019;35(4):e3139.

George MG, Fischer L, Koroshetz W, Bushnell C, Frankel M, Foltz J, et al. CDC Grand Rounds: Public Health Strategies to Prevent and Treat Strokes. MMWR Morb Mortal Wkly Rep. 2017;66(18):479-48

Katan M, Luft A. Global Burden of Stroke. Semin Neurol. 2018;38(2):208-211.

Ding C, Wu Y, Chen X, Chen Y, Wu Z, Lin Z, et al. Global, regional, and national burden and attributable risk factors of neurological disorders: The Global Burden of Disease study 1990-2019. Front Public Health. 2022;10:952161.

GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20(10):795.

Lau LH, Lew J, Borschmann K, Thijs V, Ekinci EI. Prevalence of diabetes and its effects on stroke outcomes: a meta‐analysis and literature review. . Diabetes Investig. 2019;10(3):780-92.

Echouffo-Tcheugui JB, Xu H, Matsouaka RA, Xian Y, Schwamm LH, Smith EE, et al. Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke. Eur Heart J. 2018;39(25):2376-86.

Maida CD, Daidone M, Pacinella G, Norrito RL, Pinto A, Tuttolomondo A. Diabetes and ischemic stroke: an old and new relationship an overview of the close interaction between these diseases. Int J Mol Sci. 2022;23(4):2397.

Mosenzon O, Cheng AY, Rabinstein AA, Sacco S. Diabetes and stroke: what are the connections?. J stroke. 2023;25(1):26-38.

Hu CC, Low A, O'Connor E, Siriratnam P, Hair C, Kraemer T, Sahathevan R. Diabetes in ischaemic stroke in a regional Australian hospital: uncharted territory. Int Med J. 2022;52(4):574-80.

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

Morsy EY, Rohoma KH, Mohamed Ali SA, Elhalawany SH. Comparison study of clinical presentation and risk factors for cerebrovascular stroke in diabetic versus nondiabetic patients. Egypt J Intern Med. 2022;34(1):78.

S V Birajdar, S S Chavan, S S Awachar. Study of clinical profile of stroke in diabetic and non-diabetic patients at tertiary care hospital. MedPulse International Journal of Medicine. 2022; 22(2): 24-29.

Patil AS, Tikait NU, Dange NN, Chougule S, Patil SA. Comparison of clinical presentation and risk factors of stroke in diabetic versus non-diabetic population- results of a single centre study. J. Evolution Med. Dent. Sci. 2017;6(41):3264-3268.

Sohail A Siddiqui, Ahmed M, Haq A, Ahmed A, Pir A Hayee Qureshi. “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);