In the two minutes it takes you to scan this article, an American adult with diabetes will be hospitalized for a stroke. In fact, according to the Centers for Disease Control and Prevention (CDC), more than 37 million Americans living with diabetes are 2 to 4 times more likely to have a stroke than those without the disease.
While these numbers are shocking, some people are unaware that diabetes and stroke are much more connected than they think. With this in mind, if you’re living with prediabetes or diabetes it’s important to understand this relationship so you can take steps to stay healthy and lower your risk.
The connection between diabetes and stroke
Blame it on glucose (sugar) levels. Most of the food we eat is broken down into glucose to give us energy, but to do this it requires a hormone called insulin. When glucose enters our bloodstream, most of us produce the right amount of insulin to use the glucose as energy or to store it for later.
But for those with diabetes, that’s not the case. If you have diabetes, you either don’t make enough insulin or none at all, which can lead to too much glucose or sugar in your blood. When glucose or blood sugar levels become too high, they cause proteins in the inner lining of blood vessels to accumulate. These proteins promote the formation of plaque (or hardening of the arteries), which makes the lining of the arteries rough and sticky.
“Most strokes and heart attacks eventually happen when a blood clot forms inside an artery, and that is more likely to occur when arteries are rough,” said Jeremy Payne, MD, PhD, a neurologist with Banner – University Medicine Neuroscience Clinic. “These clots can narrow or block blood vessels in the neck or brain, cutting off the blood supply and stopping oxygen from getting to the brain—eventually causing a stroke."
Diabetes and stroke also share common risk factors
Having diabetes increases your risk for stroke, but your risk is even greater if:
- you have high glucose levels
- you have high blood pressure
- you have high cholesterol
- you have heart disease
- you have a family history of strokes
- you are a smoker
- you have excessive belly fat
Lowering your risk for stroke starts with your doctor
Although diabetes can put you at greater risk for a stroke, there are things you can do to help lower your chances. The first, Dr. Payne said, starts with your relationship with your healthcare provider.
“We know an awful lot about diabetes and have a tremendous list of medication strategies to choose from that work very well,” he said. “However, that requires regular interaction with your doctor to monitor how well they’re working and how well you’re tolerating them. The great irony for me is that we know so much about diabetes, and have so many effective ways to treat it, but we’re still not good enough connecting that to our patients.”
Be sure to see your doctor regularly and to keep them informed about changes in your body or the way you feel. Regular testing can also help monitor your progress and help your doctor track your blood glucose and cholesterol levels.
“I joke with patients often that your doctor is not going home with you. Ask them what your medicines do, what to expect for results and side effects and then give your doctor feedback about how things are going at home so that adjustments can be made,” Dr. Payne said. “You yourself need to advocate for your care and ask questions (and get them answered). Most strokes and heart attacks can be prevented — at least 80% of them — but only if we have a chance to work out your individual needs first.”
Other ways to lower your risk
The other two ways you can lower your risk for stroke if you have diabetes are through regular exercise and a healthy diet. “Diabetes hates it when you exercise and pay attention to your diet and weight,” Dr. Payne said.
Exercise Regularly – The World Health Organization (WHO) recommends 150 minutes of vigorous activity per week, but if that sounds like a lot—it may because it is.
“If that sounds like too much, my best advice comes from Jerry Seinfeld: ‘Don’t break the chain,’” Dr. Payne said. “It turns out that most of the benefits for the big three diseases (stroke, heart disease and Alzheimer’s disease and dementia) seems to happen with more modest exercise. Just move and do something every day. Congratulate yourself on your daily streak and try to add on to that time.”
If you’re already in better shape, there is some evidence that high-intensity interval training (HIIT) seems to improve control of blood sugars and replace fat with muscle.
Mediterranean Diet – “A healthy balanced diet, avoiding processed foods and high sugar content while emphasizing plant-based sources of protein improves diabetes, and directly lowers the chances of the same big three diseases,” Dr. Payne said. “The Mediterranean diet does this well.”
[For other stroke prevention tips, check out our “Stroke Prevention“ article]
Do you believe you may be at risk for a stroke?
Schedule an appointment with your health care provider or a Banner Health neurologist. You can also learn more about your risk for stroke by taking our free Stroke Risk Profiler and read about prevention tips to lower your risk. For more information on stroke care, visit bannerhealth.com.