Association between diabetes and stroke subtype on survival and functional outcome 3 months after stroke: data from the European BIOMED Stroke Project.
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.
Megherbi
Salah-Eddine
SE
Stroke Registry of Dijon, Faculty of Medicine of Dijon, Burgundy University, Dijon, France.
Milan
Chantal
C
Minier
Dominique
D
Couvreur
Grégory
G
Osseby
Guy-Victor
GV
Tilling
Kate
K
Di Carlo
Antonio
A
Inzitari
Domenico
D
Wolfe
Charles D A
CD
Moreau
Thibault
T
Giroud
Maurice
M
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