Endocrine Abstracts

Introduction: Rising stroke rates call for a closer look at risk factors such as hypertension, diabetes and obesity. The established association of diabetes mellitus with stroke risk and potential post-stroke complications underscores the need for thorough analysis to effectively mitigate these challenges.

Objective: This review aims to determine the prevalence of diabetes in acute stroke patients and investigate its association with post-stroke outcomes, encompassing both ischemic and haemorrhagic strokes.

Methods: A prospective study spanning 14 months (07.01.22 to 17.10.23) was conducted at the FH - Sousse emergency department. It included individuals aged 18 years and above presenting with abrupt or rapidly progressive focal neurological deficits, or transient ischemic attacks (TIAs) lasting less than one hour, after excluding other potential diagnoses. Both diabetic and non-diabetic patients were included in our study population.

Results: Our study included 150 patients, with a mean age of 66.02 +/- 12.59. a male predominance was observed with a sex ratio of 1.54. 85.3% of our patients had associated comorbidities, notably hypertension and diabetes (55.3% and 47.3% of cases respectively). Almost half of our population (40.7%) had a history of a vascular accident, with an ulterior cerebral stroke in 51.9% of the cases and TIA in 9.6%. upon admission, all of our patients benefited from a cerebral CT scan. 44.8% of our patients had a normal CT scan while an angiography was required in 10.6% of the cases. An ischemic stroke was found in 73.4% of our patients, while 16.7% were diagnosed with haemorrhagic stroke and 10% with TIA. The most affected territory was that of the MCA in 57.9% of the cases. 22.7% of our patients were deemed having a severe presentation through clinical and imagery data observation, of whom 6.3% needed IMV, with a total mortality rate of 3.6%. Comparing diabetic and none diabetic patients, the former had significantly more comorbidities (P<10^-3) in univariate analysis: hypertension (OR= 2.6 IC [1.34-5.109], P=0.04) and dyslipidaemia (OR=4.075, IC [2.029-8.183]; P<10^-3), with only dyslipidaemia being retained in multivariate analysis (OR=5.014 IC [2.261-11.118]; P<10^-3). Diabetics also had a significantly more elevated risk of ischemic stroke in multivariate analysis (OR=4.607 IC [1.845-11.502]; P<10^-3), but had no impact on mortality (P=0.111).

Conclusion: The study examines diabetes prevalence and its impact on stroke outcomes. It highlights the common occurrence of hypertension and diabetes among stroke patients, emphasizing the need to address these risk factors.

Keywords: diabetes mellitus, stroke, outcome.