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Long-Term Diabetes Predicting The Risk of Stroke

New research shows duration a greater predictor than glycemic control or A1C.

Usually patients who have diabetes also have other comorbidities in combination with the condition, but a recent study has shined a light on the relationship between diabetes and stroke.  A large number of people with diabetes are diagnosed with metabolic syndrome, which is closely connected with stroke.  Metabolic syndrome is also associated with as above normal weight, hypertension, and hyperlipidemia. Together these three ailments lead to cardiovascular conditions that can result in blood clots.  Ischemic strokes are a result of the blood clots that form in individuals. This study specifically measured the risk of stroke using the duration of diabetes in comparison with using glycemic control.  With this information, physicians will be able to use anticoagulation prophylaxis to prevent this event from happening, or even carefully monitor and control their patients’ hyperglycemia to a point where medications aren’t needed.

Jeffrey Ashburner, one of the study’s authors, was quoted in Medpage Today as saying that diabetes is a recognized risk factor for stroke, and it is used for the prediction of stroke in AFib patients.  With that information, a lengthy study over a number of years was performed to see if those findings held true.  Based out of California, a cohort community-based study was conducted among diabetes patients identified as having AFib and monitored from the years 1996 to 2003.

A total of 2,101 patients were used to gather information for analysis.  About 40% of the population was said to have been living with diabetes for less than 3 years, while 60% of the patients had diabetes for over 3 years. Out of the total number of patients assessed, 1,933 had measured A1C levels, and 46% had levels below 7%.  About 19% of the individuals had an A1C over or equal to 9%.  Researchers also concluded that patients with the disease over 3 years had an increased rate of ischemic stroke compared to the latter.  Patients over 75 years of age and patients under 75 had an increased risk of stroke if they had diabetes over 3 years.  It can be concluded from that data  that patients who had diabetes for over 3 years were also older adults.

When comparing duration to glycemic control, researchers found that glycemic control and A1C levels did not significantly point to stroke as did duration.  Different A1C levels were used, but each solidified the researchers’ claims of duration determining stroke risk.

Although this new information is extremely beneficial to know, more studies should be conducted to cement the claims.  Patients who do not have AFib should be assessed, and a longer trial should be instituted.

Practice Pearls:

  • According to the ADA, having diabetes increases your chance of having a stroke 1.5 times more than a person without diabetes.
  • Lowering blood glucose, blood pressure, weight, and cholesterol will lower chances of having a stroke.
  • Stroke symptoms include: weakness on one side of body, trouble talking, vision impairment, and/or sudden confusion.

Ashburner, Jeffrey M. et al. “Effect Of Diabetes And Glycemic Control On Ischemic Stroke Risk In AF Patients”. Journal of the American College of Cardiology 67.3 (2016): 239-247. Web. 25 Jan. 2016.

Medpagetoday.com,. “Duration Of Diabetes Strong Marker For Stroke”. N.p., 2016. Web. 25 Jan. 2016.

American Diabetes Association,. “Stroke”. N.p., 2016. Web. 25 Jan. 2016.

Researched and prepared by Samantha Ferguson, Doctor of Pharmacy Candidate University of FAMU College of Pharmacy