Spotlight on stroke in type 2 diabetes: How the risk of these
devastating events can potentially be reduced
If you are living with type 2 diabetes, your doctor has probably
asked you to make healthy lifestyle choices to help lower your risk of
cardiovascular disease—and rightly so! We have previously discussed
the connection
between type 2 diabetes and heart disease, and this
article explains that having type 2 diabetes increases your risk
of stroke or heart attack by 2-4 times compared with someone without
type 2 diabetes1,2.
Wondering how to start a conversation with your doctor?
Here's a guide to
help you have a good conversation with your healthcare provider about
the current state of your type 2 diabetes with regards to
cardiovascular risks.
Watch the video below to discover the importance of making lifestyle
changes to support your cardiovascular health. In the video, Jean
shares her experiences of having a stroke following a diagnosis of
type 2 diabetes.
To find out more, read on.
Cardiovascular disease and where stroke comes into it
Let’s start with a recap on terminology: cardio means related to the
heart, vascular means related to the blood vessels.
The medical term for a stroke is a cerebrovascular
accident3. Cerebro means related to the brain and we know
that vascular means related to the blood vessels3. In this
blog post, we want to explain why people with type 2 diabetes are at
increased risk of suffering a stroke and what can be done to help
prevent it from happening, including the role that your diabetes
medicine could play1.
What happens during a stroke?
Although your brain is about 2% of your body weight, its intense
activity means that it consumes about 20% of the oxygen that enters
your body4.
Brain facts
Oxygen reaches the brain through the blood, so to ensure normal
functioning of the brain, it’s important that its blood supply remains steady6.
A stroke can have a significant effect on physical and mental health.
It can cause pain, difficulty with movement and pain. In addition,
those who have experienced strokes can experience problems with
thinking, memory and speech. Some people also experience emotional
problems, such as depression7.
Unfortunately, when people with diabetes have a stroke, they are at
an increased risk of dying or being left with a long-term
disability, versus someone without diabetes8.
Why does type 2 diabetes increase stroke risk?
Our blog
post on heart disease explains that when there is damage to blood
vessels, fatty material (sometimes referred to as ‘plaque’) can build
up and obstruct the blood flow in a process known as atherosclerosis.
Atherosclerosis can build up for many years without you knowing—it is
a silent disease, and a stroke can happen suddenly9.
Uncontrolled blood sugar levels in people with diabetes damage the
walls of the blood vessels, thereby speeding up the process of
atherosclerosis9. People with diabetes also tend to have
high levels of the types of fats in their blood that get turned into plaques10,11.
High levels of sugar in the blood also make blood more likely to
stick together to form clots12. When a clot reaches the
brain, it can lead to a stroke7.
How your self-care helps lower your risk
Some risk factors for stroke can be kept in check by making your
lifestyle as healthy as possible. Here are some things that you can do13-16:
Eat a healthy, balanced diet that is low in cholesterol and
salt
Stop smoking
Only drink alcohol within
recommended limits
Exercise regularly
Maintain a
healthy weight
You can read more about lifestyle changes promoting cardiovascular
health in this blog post1,2,13-16.
Reducing your risk further with help from your diabetes doctor
You might already know about medicines that work to reduce certain
risk factors for cardiovascular diseases, like medicines that reduce
cholesterol or high blood pressure. If you haven’t had your
cholesterol or blood pressure checked in a while, why not make a note
to ask your doctor if it’s worth checking that they are under control?
As someone with type 2 diabetes, even if your diabetes and all of
your other risk factors for cardiovascular disease are
well-controlled, you may still, unfortunately, have a higher risk of
developing cardiovascular disease than the general population. Only 6%
of people with type 2 diabetes are thought to have the risk under control17.
Talk to your diabetes doctor to ensure you are on the right
treatment to help you manage your risks.
Here’s
a guide to help you have a good conversation with your healthcare
provider about the current state of your type 2 diabetes with regards
to cardiovascular risks.
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References
Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, et al.
Type 2 diabetes and cardiovascular disease: Have all risk factors
the same strength? World J Diabetes. 2014;5:444-470. doi:
10.4239/wjd.v5.i4.444
Lüscher TF, Creager MA, Beckman JA, et
al. Diabetes and vascular disease: pathophysiology, clinical
consequences, and medical therapy: Part II. Circulation.
2003;108:1655-1661. doi: 10.1161/01.Cir.0000089189.70578.E2
Cleveland Clinic. Cerebrovascular Disease. Available at:
https://my.clevelandclinic.org/health/diseases/24205-cerebrovascular-disease.
Last accessed: January 2024.
Association for Psychological Science. Myth: We Only Use 10% of
Our Brains. Available from:
https://www.psychologicalscience.org/teaching/myth-we-only-use-10-of-our-brains.html.
Last accessed: January 2024.
MedlinePlus. Cerebral
hypoxia. Available from:
https://medlineplus.gov/ency/article/001435.htm. Last accessed:
January 2024.
American Diabetes Association. Stroke.
Available from:
https://www.diabetes.org/diabetes/complications/stroke. Last
accessed: January 2024.
Kaarisalo MM, Räihä IJ, Sivenius
J, et al. Diabetes worsens the outcome of acute ischemic stroke.
Diabetes research and clinical practice. 2005;69 3:293-298.
National Heart, Lung and Blood Institute. Atherosclerosis.
Available from:
https://www.nhlbi.nih.gov/health-topics/atherosclerosis. Last
accessed: January 2024.
Funk SD, Yurdagul A, Orr AW.
Hyperglycemia and endothelial dysfunction in atherosclerosis:
lessons from type 1 diabetes. Int J Vasc Med. 2012;2012:569654. doi:
10.1155/2012/569654
Dokken BB. The Pathophysiology of
Cardiovascular Disease and Diabetes: Beyond Blood Pressure and
Lipids. Diabetes Spectrum. 2008;21:160-165. doi:
10.2337/diaspect.21.3.160
Lemkes BA, Hermanides J, Devries
JH, et al. Hyperglycemia: a prothrombotic factor? J Thromb Haemost.
2010;8:1663-1669. doi: 10.1111/j.1538-7836.2010.03910.x
Drenjančević-Perić I, Jelaković B, Lombard JH, et al. High-salt
diet and hypertension: focus on the renin-angiotensin system. Kidney
Blood Press Res. 2011;34:1-11. doi: 10.1159/000320387
Pan
B, Jin X, Jun L, et al. The relationship between smoking and stroke:
A meta-analysis. Medicine (Baltimore). 2019;98:e14872. doi:
10.1097/md.0000000000014872
Mukamal KJ, Chen CM, Rao SR, et
al. Alcohol consumption and cardiovascular mortality among U.S.
adults, 1987 to 2002. J Am Coll Cardiol. 2010;55:1328-1335. doi:
10.1016/j.jacc.2009.10.056
Venkatasamy VV, Pericherla S,
Manthuruthil S, et al. Effect of Physical activity on Insulin
Resistance, Inflammation and Oxidative Stress in Diabetes Mellitus.
J Clin Diagn Res. 2013;7:1764-1766. doi:
10.7860/jcdr/2013/6518.3306
Wright AK, Suarez-Ortegon MF,
Read SH, et al. Risk Factor Control and Cardiovascular Event Risk in
People With Type 2 Diabetes in Primary and Secondary Prevention
Settings. Circulation. 2020;142:1925-1936. doi:
10.1161/circulationaha.120.046783
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