This chapter discusses the key findings from the literature regarding stroke incidence in patients with diabetes (DM), DM-specific
and non-specific risk factors of stroke in the diabetic population, course and outcome of stroke in subjects with DM, and
the peculiarities of type, site, and size of stroke in diabetic patients. The results of major clinical trials aimed at correcting
hyperglycemia, hypertension, and dyslipidemia to prevent stroke in people with DM are also reviewed.
DM has been consistently shown to represent a strong independent risk factor of ischemic stroke. The same applies to the full
cluster of the insulin resistance syndrome. The contribution of hyperglycemia to increased stroke risk is not proven. The
association of diabetes with the risk of hemorrhagic stroke remains controversial. The course of stroke in patients with DM
is characterized by higher mortality, more severe disability, and higher recurrence rate compared to non-diabetic subjects.
Aggressive control of arterial hypertension and dyslipidemia allows to substantially decrease the risk of stroke in diabetic
patients, while the importance of glucose control for stroke prevention remains unproven.
Key words Diabetes mellitus – Hyperglycemia – Stroke – Cerebral infarction – Cerebral ischemia – Stroke prevention