Did you know that living with diabetes increases your risk of stroke? People with diabetes have double the risk of stroke compared to people without diabetes, especially if their blood sugar is not well controlled. Patients with poorly controlled diabetes also have a higher risk of disability and death following a stroke.
People with diabetes are also more likely to have a stroke at an earlier age compared to people without diabetes. Even prediabetes can increase your risk of stroke and heart disease. Controlling diabetes and other risk factors of stroke is key to preventing a first or subsequent stroke.
How Diabetes Increases Stroke Risk
People with diabetes can’t manage blood sugar levels without some type of intervention: medications, diet, exercise or a combination. Having high blood sugar levels can damage the arteries that feed the brain. High blood glucose, or high blood sugar, can also harden arteries and lead to plaque buildup in the blood vessels. This buildup can ultimately cause the artery to narrow, making it more likely for a blood clot to get stuck. Cutting off blood flow to the brain can cause an ischemic stroke, which is the most common type.
Alternatively, having diabetes can weaken the blood vessels, causing them to rupture or tear, which allows the blood to leak out over the brain. This results in a hemorrhagic stroke, which is a type of stroke that occurs when bleeding on the brain compresses and damages brain tissue.
Risk Factors for Diabetes and Stroke Linked to Heart Disease
Many of the risk factors for diabetes and stroke overlap with risk factors for heart disease, too. For instance, diabetes is a risk factor for both heart disease and stroke. Several other risk factors increase the likelihood of having diabetes, heart disease or a stroke, including:
- High blood pressure
- High cholesterol
- Smoking
- Obesity (a BMI of 30 or higher)
- Lack of physical exercise
- Poor nutrition
- Being 65 years or older
- Family history of stroke
- Prior stroke
Remember the ABCs for Lowering Stroke Risk for People with Diabetes
To reduce your risk of experiencing a diabetes-related stroke, a helpful acronym, ABCs, may help. These are four important risk factors to address when you have diabetes to lower your risk of stroke.
A1c: Hemoglobin A1c is a blood test that averages your blood sugar levels over a three-month period. If you have diabetes, it is important to keep your A1c below seven percent or at the target that your doctor sets for you.
Blood pressure: High blood pressure can damage your heart and the arteries, leading to other areas of the body and increasing your risk for heart disease or stroke. It can also weaken blood vessels, making them more likely to rupture or tear. Your doctor will set a target blood pressure, which may be monitored in the office or at home. Lifestyle changes and medications can help to lower your blood pressure to your goal.
Cholesterol: Too much cholesterol can lead to plaque buildup in the arteries, so it is important to work with your doctor to keep your cholesterol level within normal range through medications, diet and exercise. Your doctor may monitor your cholesterol level through a blood test.
Stopping smoking: Smoking increases your risk of heart disease and stroke regardless of whether or not you have diabetes. To reduce your risk, it is important to stop smoking.
Regular check-ups for monitoring your risk factors for stroke and heart disease are key because cholesterol, blood pressure and blood sugar can all be abnormal without any noticeable symptoms.
Reducing Your Risk of Stroke While Managing Diabetes
There are several other ways that people living with diabetes can help to reduce their risk of experiencing a stroke, including:
- Diet. Your doctor may recommend a specific diet or a diabetes education course to help you learn how to eat a balanced diet that limits unhealthy carbohydrates and fats while ensuring you receive enough protein, fiber and other important nutrients to stabilize your blood sugar.
- Exercise. The American Heart Association recommends 150 minutes of moderate-intensity exercise per week. This amount could be met by walking briskly for 30 minutes five days a week.
- Foot care. Diabetes can damage the blood vessels in the legs and feet, leading to peripheral artery disease. This disease increases your risk of slow-healing wounds or diabetic ulcers. Infections can also increase your risk of stroke. Receive regular foot exams, regardless of if you have a wound, to check the sensation in your feet, as diabetes can damage the nerves in the foot. Sometimes, footwear, such as closed-toed orthopedic shoes, are recommended to reduce the risk of injury for people with nerve damage in their feet.
- Medications. There are a lot of new medications for diabetes available that can help to reduce your risk of stroke. Your doctor will determine which of these is best for you. It is important that you take your medications as prescribed.
- Surgery. Your doctor will listen to the carotid arteries in your neck. If an abnormal sound is heard, they may send you for an ultrasound of the carotid arteries or other imaging to check for blockage. If the carotid arteries are more than 70 percent blocked, a vascular surgeon may be consulted to discuss a type of bypass surgery in the neck to restore blood flow to the brain.
Regardless of the presence of diabetes or not, it is important to be able to recognize the symptoms of a stroke so that you or someone you’re with can receive timely care in the event that you or they have a stroke.
If you think you may be having a stroke, you should call 911 immediately. Prompt treatment increases the likelihood of recovery. Medications to dissolve a blood clot and reverse the effects of the stroke, such as tPA, can only be given within the first three hours of stroke symptom onset, but it can make a big difference in survival and recovery from having a stroke.
Listen to a Podcast
Did you know that there is a relationship between diabetes and stroke? In this podcast, Ardelia Morris, MA, RDN, CDCES, Registered Dietitian and Certified Diabetes Care and Education Specialist at UM Rehabilitation and Orthopedic Institute, part of the UM Rehab Network, dives into the complex relationship between diabetes and stroke, from risk factors to lifestyle modifications and much more.
More to Read
- Treatments for Pain Caused by Peripheral Diabetic Neuropathy
- Living with Diabetes: Empower Yourself to Stay Healthy
- Medical Nutrition Therapy for Diabetes Management
- Is It Safe to Exercise After Taking Insulin?
Medically reviewed by Ardelia Morris, MA, RDN, CDCES.
