It is estimated that the risk of stroke is increased by 1.5-3 fold for patients with diabetes. Diabetes also doubles the risk of stroke recurrence, and stroke outcomes are significantly worse among patients with diabetes with increased mortality, more residual neurological deficit and longer hospital stays.
Diabetes increases the risk of ischaemic stroke more than haemorrhagic stroke. Despite the higher prevalence of stroke in patients with diabetes, they have been shown to be less likely to develop transient ischaemic attack.
Tight glycaemic control is recommended to prevent microvascular complications, but its benefits on macrovascular disease and stroke risk are still unproven. The management of patients with diabetes and acute stroke should include multifactorial intervention - antihypertensive, lipid-lowering and antiplatelet agents and, where appropriate, surgical intervention.