CLINICODEMOGRAPHIC PROFILE AND RISK FACTORS OF STROKE IN DIABETIC AND NONDIABETIC PATIENTS IN VINDHYA REGION

BACKGROUND Stroke is defined as abrupt onset of neurologic deficit that is attributable to a focal vascular cause. It represents the second most common cause of mortality and the third most common cause of disability in developed countries. Diabetes is an important risk factor for ischemic stroke and the risk of ischemic stroke in patients with diabetes is twice as in those without diabetes. Hence the need of a study to assess the pattern of stroke, clinical profile and risk factors in diabetes mellitus and nondiabetic patients. MATERIALS AND METHODS This was a cross sectional study conducted on 500 patients of stroke for a duration of one year. Written informed consent was taken from all patients. History, clinical examination and radiological investigations (CT Scan/ MRI) was done for confirmation of stroke. Haematological and biochemical examination (HbA1c and Lipid profile) were done. ECG was done to rule out CAD. RESULTS Out of 500 patients, 72.8% had ischemic stroke and 27.2% had haemorrhagic stroke. Diabetic patients had greater probability of ischemic stroke (81.73%). Stroke was more common in males with a male to female ratio of 1.52:1. (60.4% vs 39.6%). Young stroke (≤45 year) comprised of 12.8% patients. 52.4% patients were hypertensive. In diabetic group, hypertension was present in 60.09% and in nondiabetics 46.91%, and this was significant (p value-0.00046). Diabetic hypertensives have significant association with ischemic stroke. 86.5% of the diabetic patients had HbA1c >6.5 % reflecting poor glycemic control. 99.3% patients in nondiabetic group had HbA1c<6.5 %. HbA1c is positively associated with ischemic stroke (p – value was <0.05). CONCLUSION This study shows that diabetes mellitus increases the risk of ischemic stroke. Diabetic stroke patients were younger as compared to nondiabetic stroke patients. Hypertension, poor glycemic control, dyslipidemia, obesity, smoking and tobacco chewing increases the risk of ischemic stroke. Thus, we can use glycemic control, HbA1c and duration of diabetes as a predictor of stroke