Is diabetes an independent risk factor for in‐hospital complications after a stroke?

Background Patients with diabetes mellitus ( DM ) are more likely to develop in‐hospital complications ( IHCs ) than patients without DM . In addition, they have poorer outcomes after an ischemic stroke ( IS ). Our goal was to evaluate whether the increase in risk for the development of IHCs in patients with IS is due to DM   per se , to poor metabolic control of the DM or to glucose levels on admission. Methods An observational study that included 1137 consecutive IS patients admitted to a stroke unit. Demographic data, vascular risk factors, stroke severity, on‐admission glycemia and IHC were compared between patients with and without DM . Multivariate logistic regression analyses were performed to identify factors associated with IHCs . Results Of all included patients, 283 (24.8%) had a previous diagnosis of DM . These patients were older and had higher comorbidity, with no differences in stroke severity. They presented on‐admission glycemia ≥155 mg/dL more often and suffered IHCs more frequently (24% versus 17.7%, P  = 0.034). However, after adjusting for baseline differences, DM was not associated with the development of any IHC , whereas on‐admission glycemia ≥155 mg/dL (odds ratio: 1.959; 95% CI 1.276–3.009; P  = 0.002) and stroke severity (odds ratio: 1.141; 95% CI 1.109–1.173; P  < 0.001) were the primary predictors of the development of IHCs . Conclusions Although IS patients with DM more often suffered IHCs , previous diagnosis of DM is not per se associated with the risk of IHCs . Stroke severity and on‐admission glycemia ≥155 mg/dL were the most significant predictors for the development of IHCs .