• Bareen Homoud, Alanoud Alhakami, Malak Almalki, Miselareem Shaheen, Alaa Althuabiti, Ali AlKhathaami, and Ismail A Khatri.
• From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2020 Nov 1; 40 (6): 449-455.

BackgroundDiabetes mellitus increases stroke risk 1.5 to 3 fold, particularly ischemic stroke. There is limited literature on the impact of diabetes on stroke patients in Saudi Arabia.ObjectivesDetermine the association of diabetes on the presentation, subtypes, in-hospital complications and outcomes of ischemic stroke and transient ischemic attacks (TIA).DesignIRB approved, retrospective chart review.SettingTertiary care center.Patients And MethodsAll adult patients with ischemic stroke or TIA aged 18 years or older admitted from January 2016 to December 2017 were included.Main Outcome MeasuresStroke severity at presentation, stroke-related complications, discharge disposition and discharge modified Rankin Scale (mRS) in relation to diabetes.Sample Size802 patients.ResultsAmong 802 cases, 584 (72.8%) had diabetes; the majority (63.1%) were males. The mean age was younger in the non-diabetic stroke group (54.6 [15.5] years vs. 63.3 [9.9], P<.001). Hypertension (83.6% vs 49.1%, P<.001), dyslipidemia (38.9% vs. 28.9%, P=.009), prior stroke (27.7% vs. 19.3% P=.014), and ischemic heart disease (20.4% vs. 7.8%, P<.001) were more common in diabetic patients whereas smoking was more common (19.3% vs. 11.1%, P=.003) in the non-diabetic patients. The commonest subtype of stroke was large artery disease followed by small vessel disease. Both were more common in diabetic vs. non-diabetic patients (55.8% vs. 44%, P=.003), and (16.6% vs. 11%, P=.05) respectively. Diabetic stroke patients were more likely to have lacunar stroke (16.4% versus 9.2%, P=.009). TIAs occurred more commonly in the non-diabetic group (26.1% vs. 13.7%, P<.001). Non-diabetic patients had a better outcome (mRS score of 0-2) at discharge (62.4% vs. 45.9%, P=.002).ConclusionsAlmost three-fourth stroke patients were diabetic in our cohort. Diabetic stroke patients were older, had multiple vascular comorbid conditions, presented late to the hospital, and were likely to have more disability at the time of discharge. Large vessel atherosclerosis as well as lacunar infarctions were more common in diabetic stroke patients.LimitationsMissing data about time of presentation in few patients, missing modified Rankin Scale score at discharge.Conflict Of InterestNone.

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