NEW YORK (Reuters Health) – In patients with an acute ischemic stroke, diabetes does not increase the risk of death at 60 days or 1 year, but it is associated with slightly reduced long-term survival, new research shows.

“The biggest findings were the lack of increased early mortality in stroke patients with diabetes compared to those without diabetes and also the relatively modest long-term higher mortality among diabetes subjects,” lead author Dr. Masoor Kamalesh, from Indiana University in Indianapolis, told Reuters Health.

“The most likely reasons for these findings,” he said, “are better control of blood sugar in the early phase of stroke and better control of co-morbidities such as blood pressure and high cholesterol long term.”

The results, which appear in the October issue of Stroke, are based on a study of all ischemic stroke patients who were discharged from Veterans hospitals from October 1990 and September 1997.

Of the 48,733 patients identified, 98% were male and 25% had diabetes, the report indicates. The average age in diabetics and non-diabetics was comparable, hovering around 67.4 years.

During the study period, the percentage of stroke patients with diabetes rose from 25% to 31%. The prevalence of Charlson scores > 2, an indicator of more severe illness, in diabetics was 68.2%, significantly higher than the 47.9% in non-diabetics (p < 0.001). As noted, both 60-day and 1-year mortality were significantly different between the groups, roughly 2.8% and 12.8% in each, respectively. At longer follow-up, however, mortality was 15% higher in the diabetic group (p < 0.001). “Despite these favorable findings, there is no reason for physicians to be complacent while managing stroke in diabetic subjects,” Dr. Kamalesh emphasized. “Meticulous control of blood sugar and co-morbidities of high blood pressure and high cholesterol should be aggressively managed in these subjects to keep favorable trends continuing.” Reference:
Stroke 2008;39:2727-2731.