title: Association between diabetes and stroke subtype on survival and functional outcome 3 months after stroke: data from the European BIOMED Stroke Project.
abstract: OBJECTIVE
  Although diabetes is a strong risk factor for stroke, it is still unclear whether stroke subtype, severity, and prognosis are different in diabetic and nondiabetic patients. We sought to evaluate stroke features, prognosis, and functional outcome in patients with diabetes compared with patients without diabetes.
  
  
  METHODS
  In a European Union Concerted Action involving 7 countries and 4537 patients hospitalized for a first-in-a-lifetime stroke, defined according to the Oxfordshire Community Stroke Project criteria, we collected data on demographics, risk factors, clinical presentation, and outcome. We used logistic regression to examine the relationship between diabetes and outcome at 3 months (disability, handicap, and death), controlling for risk factors, clinical presentation, and demographics.
  
  
  RESULTS
  Overall, diabetes was present in 937 patients (21%). Diabetic patients, compared with those without diabetes, were more likely to have limb weakness (P<0.02), dysarthria (P<0.001), ischemic stroke (P<0.001), and lacunar cerebral infarction (P=0.03). At 3 months, the case fatality rates were not higher in the diabetic groups (P=0.33). Handicap (Rankin Scale) and disability (Barthel Index) were significantly higher in diabetic patients (P=0.005 and P=0.016, respectively).
  
  
  CONCLUSIONS
  Stroke in diabetic patients has a specific clinical pattern and a poor prognosis in terms of motor function, which emphasizes the need for early diagnosis and treatment of every case of diabetes.
authors.affiliation: Stroke Registry of Dijon, Faculty of Medicine of Dijon, Burgundy University, Dijon, France.
authors.forename: Salah-Eddine
authors.initials: SE
authors.lastname: Megherbi
authors.forename: Chantal
authors.initials: C
authors.lastname: Milan
authors.forename: Dominique
authors.initials: D
authors.lastname: Minier
authors.forename: Grégory
authors.initials: G
authors.lastname: Couvreur
authors.forename: Guy-Victor
authors.initials: GV
authors.lastname: Osseby
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.forename: Charles D A
authors.initials: CD
authors.lastname: Wolfe
authors.forename: Thibault
authors.initials: T
authors.lastname: Moreau
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000175:diagnosis / Q000401:mortality / Q000534:rehabilitation; D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality / Q000534:rehabilitation; D015897:Comorbidity; D003710:Demography; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D004185:Disability Evaluation; D004401:Dysarthria / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000453:epidemiology; D011379:Prognosis; D020127:Recovery of Function; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality; D000071939:Stroke Rehabilitation; D015996:Survival Rate; D016896:Treatment Outcome