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Clinical Summary

Newly diagnosed diabetes raises risk for poor outcomes in stroke patients

Takeaway

  • Acute stroke patients (ASPs) with newly diagnosed diabetes mellitus (NDDM) showed significantly higher rate of poor functional outcome and mortality on admission and 3 months post-stroke vs ASPs with previously diagnosed diabetes mellitus (PDDM).

Why this matters

  • Limited data are available on the association between diabetes and stroke, particularly regarding the outcome among ASPs with NDDM.

Study design

  • Hospital-based prospective cohort study included 701 ASPs (ischaemic stroke: n=480; PDDM: n=174; NDDM: n=66).
  • Mortality and functional outcomes in the ASPs with PDDM were compared with those with NDDM.
  • Funding: None disclosed.

Key results

  • Mortality rate on admission and 3 months after stroke was higher in NDDM (P<.05).
  • Overall, 3 months poststroke mortality rate among patients with PDDM was 38.1%, whereas 77.5% of the patients survived from stroke within 3 months (log-rank test P=.008).
  • Dying risk among the ASPs with NDDM was 1.8 times higher vs ASPs with PDDM (aHR, 1.8; P=.010).
  • NDDM had a higher mean National Institutes of Health Stroke Scale and modified Rankin score (P<.05) on admission.
  • PDDM had a higher frequency of urinary tract infections during hospitalisation (P=.015).
  • No significant difference between functional outcome on admission and 3 months after stroke was seen among the ASPs (P>.05).

Limitations

  • Very few stroke patients with NDDM had their HbA1c levels controlled 3 months post stroke.

References


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