Stroke

Strokes occur often in the general population. Strokes are more common and occur at an earlier age in people with diabetes. Women with diabetes have a greater risk for having a stroke than men. The damage to large blood vessels that occurs in diabetes makes vessels narrow, still and less flexible. This slows the blood flow, causing clots. Oxygen and nutrients can no longer reach vital parts of the body. If the blood flowing to the brain slows down, a stroke may occur. Nerve cells are no longer nourished, the cells die and that part of the brain stops working.

How do you know you are having a stroke? According to the American Stroke Association* the warning signs of a stroke include:

  • Numbness or weakness in the face, arm or leg, especially on one side of the body
  • Confusion, trouble speaking or understanding
  • Trouble seeing in one or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • Severe headache with no known cause

Any of these symptoms require immediate emergency medical care. Early treatment of symptoms is needed to prevent a debilitating stroke. Exams that may be done to detect a stroke include:

  • CT scans are a test that shows the cause of a stroke.
  • MRI is a test that shows the location and extent of the brain injury.
  • EEG is a test to measure electrical pulses in the brain.
  • Carotid ultrasound is done to detect a narrowing of the arteries. If this area is clogged, it can lead to a stroke.

Important steps to take People with type 1 or type 2 diabetes are equally at risk for disease of the large blood vessels. Prevention of the disease is more likely to occur when you take good care of yourself. The way to do this is to keep your diabetes under control. The following steps are needed to protect your blood vessels.

1. Control high blood pressure. High blood pressure damages the blood vessels and kidneys and makes the heart work harder. It is the major risk factor for stroke. 2. Keep your blood sugar in normal range. You will find that as blood sugar levels improve, blood fat levels will usually improve. 3. Treat blood fat levels by eating foods low in saturated and trans fats, losing weight and exercising. High blood fats cause blood vessel walls to thicken and become narrow. 4. Stop smoking. This is the most important behavior you should change. 5. Lose weight. Obesity creates greater insulin resistance and places greater stress on the heart and body. 6. Ask your doctor to refer you to a dietitian. He/she will be able to help you modify your meal plan to improve your blood fats, improve blood sugar and help you lose weight. 7. Exercise. Try to do at least 30 minutes on most days. You can do this by walking, swimming or bicycling. Inactivity promotes obesity and fats to build-up in blood vessels. Check with your doctor before doing any exercise program. 8. Reduce stress levels. Stress can increase blood sugar levels in some individuals and prevents you from taking good care of yourself. 9. Check with your doctor about taking aspirin daily. 10. Seek immediate emergency care (911) if you have any symptoms of a stroke.

How can your doctor help you? At each visit your doctor should: 1. Evaluate your blood sugar results and adjust your diabetes medicine, if needed. If your sugar is not in range, new goals should be set. 2. Check your blood pressure. 3. Review Hemoglobin A1c results. This should be done at least 2 times per year. 4. Check blood fats every year or more often, if needed, to keep levels controlled.

*strokeassociation.org, accessed 2/27/14