title: Diabetes worsens the outcome of acute ischemic stroke.
abstract: OBJECTIVE
  To characterize acute stroke events in diabetic patients in a population-based stroke register and to determine the influence of diabetes on the outcome of acute stroke.
  
  
  METHODS
  Four thousand three hundred and ninety patients were recorded in the FINMONICA and FINSTROKE registers after their first ischemic stroke from 1990 to 1998. We followed mortality and stroke outcome for up to 4 weeks after the onset of acute stroke.
  
  
  RESULTS
  Of the 4390 patients who had had an ischemic stroke, 43.6% were male and 25.1% (1103) had diabetes. Their mean age was 72.4 (S.D. 12.0) years and this was similar in patients with and without diabetes (72.9 years versus 72.3 years, p=0.18). Subjects with diabetes were more likely to be hypertensive (55% versus 38%, p<0.001) and have a history of myocardial infarction (20% versus 16%, p<0.001) than the non-diabetic stroke patients. Mortality at 4 weeks from the onset was higher in diabetic than in non-diabetic patients (20.0% versus 16.9% p=0.020). At day 28 after the stroke attack, diabetic patients were more likely to be disabled when compared with non-diabetic subjects (43.3% versus 33.5%, p<0.001). Using logistic regression analysis, adjusted for age-group, sex, previous medical history (MI, AF or TIA), diabetes was found to be a significant predictor of disability after stroke (OR=1.51, 95% CI 1.27-1.81).
  
  
  CONCLUSIONS
  Diabetes, which affected one-fourth of the ischemic stroke patients on our register, was associated with a higher risk of death and disability after the onset of stroke. Preventing diabetes in the elderly population improves the short-term prognosis of acute ischemic stroke.
authors.affiliation: Turku City Hospital, Turku, Finland. minna.kaarisalo@utu.fi
authors.forename: Minna M
authors.initials: MM
authors.lastname: Kaarisalo
authors.forename: Ismo
authors.initials: I
authors.lastname: Räihä
authors.forename: Juhani
authors.initials: J
authors.lastname: Sivenius
authors.forename: Pirjo
authors.initials: P
authors.lastname: Immonen-Räihä
authors.forename: Aapo
authors.initials: A
authors.lastname: Lehtonen
authors.forename: Cinzia
authors.initials: C
authors.lastname: Sarti
authors.forename: Markku
authors.initials: M
authors.lastname: Mähönen
authors.forename: Jorma
authors.initials: J
authors.lastname: Torppa
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
mesh_terms: D000208:Acute Disease; D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D012042:Registries; D012307:Risk Factors; D012907:Smoking; D016896:Treatment Outcome