Table of ContentsView AllTable of ContentsDiabetes and StrokeRisksTreatmentPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Diabetes and Stroke
Risks
Treatment
Prevention
Frequently Asked Questions
Diabetes (also calleddiabetes mellitus) is a group of conditions that cause the body to be less efficient in managing levels of bloodglucose(sugar). People with diabetes are at risk of havinghigh blood glucose.
Having high blood glucose levels can harm blood vessels over time. A damaged blood vessel in the brain may become blocked or break, which causes astroke. A stroke is an emergency condition that can lead to brain damage and death.
This article will discuss the connection between diabetes and stroke, including causes, risks, and prevention.
Connection Between Diabetes and Stroke
Diabetes is a group of chronic conditions that affect the metabolic system. A metabolic disease affects how the body uses the nutrients from food to fuel the cells of the body.
When you eat, the body breaks food down and releases glucose (sugar) into the bloodstream. This causes an organ in the digestive system, the pancreas, to release a hormone calledinsulin.
In diabetes, thepancreaseither doesn’t make insulin or doesn’t make enough insulin to help the body convert all the glucose from food into energy. One of the results is a rise in the glucose level in the bloodstream.
The symptoms of diabetes can include:
An increased blood glucose level can damage blood vessels over time. Blood vessels may become blocked or burst, leaving a part of the body without a blood supply.
When this happens in the brain, a stroke can occur. The cells of the brain may die, which can impact the body in various ways, depending on which blood vessels are affected. Altered vision, memory loss, paralysis, and other signs and symptoms may result.
People who live with diabetes are twice as likely to have a stroke as people who don’t have the disease.After having a stroke, people with diabetes are also less likely to fully recover and they also have a higher risk of dying from a stroke.
People with diabetes are more likely to have hypertension (high blood pressure),hyperlipidemia(high levels of fat in the blood), coronary disease (reduced blood flow to the heart muscle), orperipheral vascular disease(reduced blood flow in vessels other than the heart). These conditions are also risk factors for a stroke.
Microalbuminuria, which is having too much of a protein called albumin in the urine, is also connected to diabetes. Having diabetes and microalbuminuria is associated with an 80% increased risk of stroke.
Historically marginalized populations, including Black, Hispanic, and American Indian populations, have a higher prevalence of acquiring both diabetes and stroke than other groups.
Treatment and Management of Stroke With Diabetes
A stroke is a medical emergency, and it’s important to get care immediately when the symptoms of a stroke are recognized. Unfortunately, people with diabetes tend to do worse after having a stroke than people who don’t have diabetes. There are recommendations for the care of stroke in people who have diabetes.
A stroke is both physically and mentally stressful. Stress can affect blood glucose levels. When you have a stroke and are admitted to a medical facility, blood glucose levels must be managed and kept to normal levels.
Blood glucose levels are often too high in people with diabetes who are hospitalized for a stroke. It is recommended to normalize the blood glucose level to 140 to 180 milligrams per deciliter (mg/dL) in the first 24 hours and maintain it for the first 48 hours after a stroke.
Normalizing blood glucose levels might also improve your outcome and lower your risk of death. Insulin is usually given to manage blood glucose levels.
Other treatments and supportive care will be given according to the type of stroke.Tissue plasminogen activator (TPA)may be given, but it must be administered within the first few hours after a stroke. TPA dissolves blood clots that cause some types of strokes.
Other blood thinners such asheparinoraspirinmay be needed when a blockage causes a stroke. Additionally, medications can help manageblood pressure.
Fluids with a balance ofelectrolytes(sodium, potassium, and calcium) may be given through an intravenous (IV) line in a slow drip to prevent swelling in the brain.
Varioussurgical procedurescan also alleviate any brain swelling or bleeding in the brain. This can include removing a small portion of the skull bone for a time until the swelling in the brain goes down, or draining or removing a brain bleed.
Poststrokerehabilitationmay includephysical therapy,occupational therapy, and speech therapy.
Rehabilitation may take place at a recovery facility if there’s a need for long-term skilled nursing care or on an outpatient basis. Many factors will be considered to decide the level of care needed, including the type of family and community support available to the person.
Prevention of stroke in people with diabetes is important and can take many forms. Healthcare providers may use a risk assessment tool to estimate the risk of stroke in a person with diabetes.
Stroke prevention measures may include making adjustments to your lifestyle. This includes changing eating habits, stopping smoking, keeping to moderate alcohol use, and getting regular exercise. These types of changes may be suggested to help control the effects of diabetes.
The two types of drugs that prevent a stroke in people with diabetes are:
High blood pressure (hypertension) is a risk factor for stroke in people who have diabetes. American Diabetes Association (ADA) guidelines recommend that people with diabetes maintain a blood pressure of less than 140/90 mmHg.
High blood pressure can be treated with medications, such asangiotensin-converting enzyme inhibitors (ACEI)or an angiotensin receptor blocker (ARB).
Dyslipidemia(high cholesterol and triglyceride levels) is another condition that can increase the risk of stroke when left untreated. For those who have dyslipidemia, medications calledstatinsmight be recommended to reduce cholesterol levels.
Other methods of preventing stroke include the use of aspirin and/or fibrate medications. Fibrates such as Lopid (gemfibrozil) lower triglyceride levels and increase HDL cholesterol. So far, aspirin or fibrates haven’t been shown to help prevent strokes in people with diabetes.
Even though it’s important to have good blood glucose levels in diabetes, strict control hasn’t been proven to reduce the risk of stroke.
More prevention methods may be used to lower the risk of having another stroke in those who have already had a stroke.
Summary
People who live with diabetes should be aware of their risk of getting a stroke. Well-controlled blood glucose levels may not lower the risk of a stroke. Lifestyle changes such asquitting smoking, eating a healthful diet, treating high blood pressure, and getting exercise are important in reducing the risks.
A Word From Verywell
People who have diabetes and those who care for them will want to familiarize themselves with the signs and symptoms of a stroke and to talk with healthcare providers about the risk of a stroke. Prevention strategies will be key.
Frequently Asked QuestionsIt’s important to recognize a stroke and get care immediately. This gives the best chance for a good outcome.Some of the signs and symptoms of a stroke include:Altered vision in one or both eyesDifficulty in talking or in understanding speechLoss of coordination or balance, dizziness, or difficulty walkingNumbness or weakness in the face or in the limbs, or on one or both sides of the bodySudden, severe headacheLearn MoreSigns and Symptoms of a StrokeMen are more likely to have a stroke, but women are more likely to die from one.For women in the United States, stroke is the fifth leading cause of death. African American women and Hispanic women have a higher prevalence of having a stroke compared to White women.The signs and symptoms of a stroke are similar in people of any sex. However, women may also experience other symptoms such as fatigue and nausea or vomiting.Learn MoreStroke Symptoms in WomenA transient ischemic attack (TIA) is also calledministroke. This happens when there is a temporary blockage of the blood flow leading to the brain. They are also sometimes called a warning stroke.It’s important to get care immediately if a mini-stroke is suspected. As many as 15% of people who have a ministroke go on to have a major stroke or another health emergency, often only days or weeks later.Learn MoreUnderstanding TIA
It’s important to recognize a stroke and get care immediately. This gives the best chance for a good outcome.Some of the signs and symptoms of a stroke include:Altered vision in one or both eyesDifficulty in talking or in understanding speechLoss of coordination or balance, dizziness, or difficulty walkingNumbness or weakness in the face or in the limbs, or on one or both sides of the bodySudden, severe headacheLearn MoreSigns and Symptoms of a Stroke
It’s important to recognize a stroke and get care immediately. This gives the best chance for a good outcome.Some of the signs and symptoms of a stroke include:Altered vision in one or both eyesDifficulty in talking or in understanding speechLoss of coordination or balance, dizziness, or difficulty walkingNumbness or weakness in the face or in the limbs, or on one or both sides of the bodySudden, severe headache
It’s important to recognize a stroke and get care immediately. This gives the best chance for a good outcome.
Some of the signs and symptoms of a stroke include:
Learn MoreSigns and Symptoms of a Stroke
Men are more likely to have a stroke, but women are more likely to die from one.For women in the United States, stroke is the fifth leading cause of death. African American women and Hispanic women have a higher prevalence of having a stroke compared to White women.The signs and symptoms of a stroke are similar in people of any sex. However, women may also experience other symptoms such as fatigue and nausea or vomiting.Learn MoreStroke Symptoms in Women
Men are more likely to have a stroke, but women are more likely to die from one.For women in the United States, stroke is the fifth leading cause of death. African American women and Hispanic women have a higher prevalence of having a stroke compared to White women.The signs and symptoms of a stroke are similar in people of any sex. However, women may also experience other symptoms such as fatigue and nausea or vomiting.
Men are more likely to have a stroke, but women are more likely to die from one.For women in the United States, stroke is the fifth leading cause of death. African American women and Hispanic women have a higher prevalence of having a stroke compared to White women.
The signs and symptoms of a stroke are similar in people of any sex. However, women may also experience other symptoms such as fatigue and nausea or vomiting.
Learn MoreStroke Symptoms in Women
A transient ischemic attack (TIA) is also calledministroke. This happens when there is a temporary blockage of the blood flow leading to the brain. They are also sometimes called a warning stroke.It’s important to get care immediately if a mini-stroke is suspected. As many as 15% of people who have a ministroke go on to have a major stroke or another health emergency, often only days or weeks later.Learn MoreUnderstanding TIA
A transient ischemic attack (TIA) is also calledministroke. This happens when there is a temporary blockage of the blood flow leading to the brain. They are also sometimes called a warning stroke.It’s important to get care immediately if a mini-stroke is suspected. As many as 15% of people who have a ministroke go on to have a major stroke or another health emergency, often only days or weeks later.
A transient ischemic attack (TIA) is also calledministroke. This happens when there is a temporary blockage of the blood flow leading to the brain. They are also sometimes called a warning stroke.
It’s important to get care immediately if a mini-stroke is suspected. As many as 15% of people who have a ministroke go on to have a major stroke or another health emergency, often only days or weeks later.
Learn MoreUnderstanding TIA
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pikula A, Howard BV, Seshadri S. Stroke and Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); August 2018.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.J Diabetes Investig. 2019;10:780-792. doi:10.1111/jdi.12932Bushnell C, Kernan WN, Sharrief AZ, et al.2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2024 Dec;55(12):e439. doi: 10.1161/STR.0000000000000482].Stroke. 2024;55(12):e344-e424. doi:10.1161/STR.0000000000000475Jauch 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;44:870-947. doi:10.1161/STR.0b013e318284056aGaillard T, Miller E.Guidelines for stroke survivors with diabetes mellitus.Stroke. 2018;49:e215-e217. doi:10.1161/STROKEAHA.118.020745Kernan WN, Inzucchi SE.Treating diabetes to prevent stroke.Stroke. 2021;52:1557-1560. doi:10.1161/STROKEAHA.120.032725Zhou Z, Jardine MJ, Li Q, et al.Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: results from the CREDENCE trial and meta-analysis.Stroke. 2020; 52:1545–1556. doi: 10.1161/STROKEAHA.120.031623American Diabetes Association.8. Cardiovascular disease and risk management.Diabetes Care. 2016;39 Suppl 1:S60-S71. doi:10.2337/dc16-S011Meschia JF, Bushnell C, Boden-Albala B, et al.Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014;45:3754-3832. doi:10.1161/STR.0000000000000046Texas Heart Institute.More strokes for men; more deadly for women.Centers for Disease Control and Prevention.Women and stroke.American Stroke Association.Transient ischemic attack (TIA).Additional ReadingAmerican Diabetes Association.2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018.Diabetes Care. 2018;41(Suppl 1):S13-S27. doi:10.2337/dc18-S002
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pikula A, Howard BV, Seshadri S. Stroke and Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); August 2018.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.J Diabetes Investig. 2019;10:780-792. doi:10.1111/jdi.12932Bushnell C, Kernan WN, Sharrief AZ, et al.2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2024 Dec;55(12):e439. doi: 10.1161/STR.0000000000000482].Stroke. 2024;55(12):e344-e424. doi:10.1161/STR.0000000000000475Jauch 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;44:870-947. doi:10.1161/STR.0b013e318284056aGaillard T, Miller E.Guidelines for stroke survivors with diabetes mellitus.Stroke. 2018;49:e215-e217. doi:10.1161/STROKEAHA.118.020745Kernan WN, Inzucchi SE.Treating diabetes to prevent stroke.Stroke. 2021;52:1557-1560. doi:10.1161/STROKEAHA.120.032725Zhou Z, Jardine MJ, Li Q, et al.Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: results from the CREDENCE trial and meta-analysis.Stroke. 2020; 52:1545–1556. doi: 10.1161/STROKEAHA.120.031623American Diabetes Association.8. Cardiovascular disease and risk management.Diabetes Care. 2016;39 Suppl 1:S60-S71. doi:10.2337/dc16-S011Meschia JF, Bushnell C, Boden-Albala B, et al.Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014;45:3754-3832. doi:10.1161/STR.0000000000000046Texas Heart Institute.More strokes for men; more deadly for women.Centers for Disease Control and Prevention.Women and stroke.American Stroke Association.Transient ischemic attack (TIA).Additional ReadingAmerican Diabetes Association.2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018.Diabetes Care. 2018;41(Suppl 1):S13-S27. doi:10.2337/dc18-S002
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Pikula A, Howard BV, Seshadri S. Stroke and Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); August 2018.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.J Diabetes Investig. 2019;10:780-792. doi:10.1111/jdi.12932Bushnell C, Kernan WN, Sharrief AZ, et al.2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2024 Dec;55(12):e439. doi: 10.1161/STR.0000000000000482].Stroke. 2024;55(12):e344-e424. doi:10.1161/STR.0000000000000475Jauch 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;44:870-947. doi:10.1161/STR.0b013e318284056aGaillard T, Miller E.Guidelines for stroke survivors with diabetes mellitus.Stroke. 2018;49:e215-e217. doi:10.1161/STROKEAHA.118.020745Kernan WN, Inzucchi SE.Treating diabetes to prevent stroke.Stroke. 2021;52:1557-1560. doi:10.1161/STROKEAHA.120.032725Zhou Z, Jardine MJ, Li Q, et al.Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: results from the CREDENCE trial and meta-analysis.Stroke. 2020; 52:1545–1556. doi: 10.1161/STROKEAHA.120.031623American Diabetes Association.8. Cardiovascular disease and risk management.Diabetes Care. 2016;39 Suppl 1:S60-S71. doi:10.2337/dc16-S011Meschia JF, Bushnell C, Boden-Albala B, et al.Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014;45:3754-3832. doi:10.1161/STR.0000000000000046Texas Heart Institute.More strokes for men; more deadly for women.Centers for Disease Control and Prevention.Women and stroke.American Stroke Association.Transient ischemic attack (TIA).
Pikula A, Howard BV, Seshadri S. Stroke and Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); August 2018.
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.J Diabetes Investig. 2019;10:780-792. doi:10.1111/jdi.12932
Bushnell C, Kernan WN, Sharrief AZ, et al.2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2024 Dec;55(12):e439. doi: 10.1161/STR.0000000000000482].Stroke. 2024;55(12):e344-e424. doi:10.1161/STR.0000000000000475
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;44:870-947. doi:10.1161/STR.0b013e318284056a
Gaillard T, Miller E.Guidelines for stroke survivors with diabetes mellitus.Stroke. 2018;49:e215-e217. doi:10.1161/STROKEAHA.118.020745
Kernan WN, Inzucchi SE.Treating diabetes to prevent stroke.Stroke. 2021;52:1557-1560. doi:10.1161/STROKEAHA.120.032725
Zhou Z, Jardine MJ, Li Q, et al.Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: results from the CREDENCE trial and meta-analysis.Stroke. 2020; 52:1545–1556. doi: 10.1161/STROKEAHA.120.031623
American Diabetes Association.8. Cardiovascular disease and risk management.Diabetes Care. 2016;39 Suppl 1:S60-S71. doi:10.2337/dc16-S011
Meschia JF, Bushnell C, Boden-Albala B, et al.Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014;45:3754-3832. doi:10.1161/STR.0000000000000046
Texas Heart Institute.More strokes for men; more deadly for women.
Centers for Disease Control and Prevention.Women and stroke.
American Stroke Association.Transient ischemic attack (TIA).
American Diabetes Association.2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018.Diabetes Care. 2018;41(Suppl 1):S13-S27. doi:10.2337/dc18-S002
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
