Endocrine Abstracts

Introduction: Strokes are common diabetes macrovascular complications. A good control of cardiovascular risk factors such as glycemic control has been proven to reduce the risk of its appearance. Aim: Describe diabetes prevalence in patients admitted to hospital because of a stroke, as well as their treatment and metabolic control.

Patients and methods: Observational retrospective study of patients admitted to the Neurology section because of a stroke between 2016 and 2017. Statistical analysis performed with SPSS (22th version).

Results: 611 patients recruited. Age: 65.13±12.72 years. 32.7% women. Mean of HbA1c 6.75±1.54%. 28 patients died during their hospital stay, 35.7% of which had a previous diabetes story. (P=0.55). Prior DM history in 187 patients (30.6%): 0.5% LADA, 1.1% DM1 and 97.9% DM2. 55.9% were treated with antidiabetic drugs, 18.4% with insulin, 12.8% with both and in 12.8% the treatment was unknown. HbA1c was requested in 72.2% of people with diabetes with a HbA1c of 7.71±1.72%. 51.9% of them met their glycemic target. In 53.2% non-diabetic people HbA1c was requested: 20 patients (4.1%) were diagnosed with diabetes (Mean HbA1c 7.06±0.72%) and 85 with prediabetes (34.7%, Mean HbA1c 5.94±0.20%). 23 patients with diabetes (12.3%) and 3 (15%) newly diagnosed were evaluated by an endocrinologist. Treatment at discharge was modified in 22.5% of patients with prior DM history (42.9% by endocrinologists and 57.1% by neurologists) and in 25% of newly diagnosed diabetic patients (40% by endocrinologists and 60% by neurologists). Most patients (68.1%) improved their ambulatory glycemic control with a mean HbA1c reduction of 0.75±1.61% (in 5.48±2.68 months). 19 patients had a worse ambulatory glycemic control and only 2 of these had been evaluated by endocrinologists.

Conclusions: 1) Diabetes prevalence in patients with stroke is high in our series, in spite of which HbA1c is not routinely evaluated.

2) Almost a half of diabetic patients (48.1%) do not meet their glycemic goal at admission. However only a small percentage (12.3%) of them are evaluated by an endocrinologist and after this evaluation most of them improve their glycemic target.