Antonino Tuttolomondo, Carlo Maida, Rosario Maugeri, Gerardo Iacopino and Antonio Pinto
Diabetes and ischemic stroke are common diseases that frequently occurring together. Among patients with diabetes mellitus several factors contribute in varying degrees to the overall cerebrovascular risk including hyperglycemia, vascular risk factors such as hypertension and dyslipidemia and also genetic, demographic, and lifestyle factors and several studies have shown that people with diabetes have approximately twice the risk of ischemic stroke compared with those without diabetes. The association between ischemic stroke and diabetes is bidirectional and it is not limited to acute ischemic stroke since diabetes may contribute to a more insidious brain damage represented by lacunar infarcts increasing the risk of dementia and leading to a steeper decline in cognitive function. The higher cerebrovascular risk profile of subjects with diabetes mellitus emphasizes the importance of secondary prevention strategies with the aim to prevent a substantial number of these disabling strokes among patients with diabetes. In this review, we describe the relationship between glucose metabolism and acute ischemic stroke and focus on the analysis of diabetes-related risk factor for stroke and on specific patterns of stroke type associated with diabetes.