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Diabetes is not only a serious condition itself but is also responsible for increasing the vulnerability for many health conditions, stroke being one of them. Studies indicate that people suffering from diabetes have around 1.5 times greater chances of having a stroke, than people who do not have it. According to World Health Organisation (WHO), total number of people with diabetes is projected to increase to 366 million in 2030 from 171 million in 2000.

Diabetes affects the capabilities of the body to create insulin or put it to best uses. Insulin plays a very important role in filtering out the glucose from the bloodstream into the cells. People who suffer from diabetes, do not have this mechanism working quite efficiently, thus they are often left with extreme amounts of sugar in their blood. As time passes by, this extra sugar leads to the building up of clots or deposits of fat inside the vessels that are responsible for supplying blood to the brain and the neck. This is nothing but the process of atherosclerosis.

As a result of these deposits growing, the blood vessels often narrow down or can even get blocked completely. When the blood flow to the brain stops, there are chances of occurrence of a stroke.

What is a stroke and what are the types of it?

For the definition of a stroke, in a layman’s terms, stroke is a condition in which the blood vessels of the brain are damaged. A number of factors characterize the occurrence of a stroke, like the place in the brain where the blood vessels have been damaged, the size of the damaged blood vessel and the event responsible for the damage. Following are the types of strokes:

• Ischaemic stroke: This is the most common type of stroke and occurs when the artery supplying oxygen-rich blood to the brain, gets blocked. Most often the bran gets blocked due to a blood clot.

• Hemorrhagic stroke: This stroke happens when the artery in the brain ruptures or leaks blood. This is a very serious kind of stroke and is responsible for 40 per cent of deaths related to strokes.

• Transient ischaemic attack: Also known as TIA, this condition is often known as a mini-stroke as the blood flow to the brain gets blocked for a certain amount of time. This stroke does not result in a permanent neurological damage. TIA may last from a minute to many hours, till the clogged artery opens back. Often referred to as a warning stroke the symptoms should not be ignored.

What are the warning signs of stroke?

1. Weakness or numbness on one side of the body
2. Sudden confusion or trouble understanding
3. Trouble talking
4. Dizziness, loss of balance, or trouble walking
5. Double vision
6. Severe Headache

As the signs develop suddenly and as STROKE is a life-threatening disease, it is important to contact the emergency department as getting treatment as soon as possible after a stroke can help prevent permanent damage to your brain

A deep connection between stroke and diabetes

As we have already understood, diabetes increases the chances of stroke. To add to this, diabetes also makes it hard for the body to respond to stroke. When the oxygen supply gets cut off, the other arteries can normalise the situation by acting as a bypass. In case, a person suffering a stroke already has diabetes, the vessels may remain clogged or hardened with plaque, a condition which is known as atherosclerosis. Thus, the brain finds it hard to receive the supply of the blood.

With the passage of time, the high blood sugar levels can damage the nerves and the blood vessels.  If the condition is not brought under control in time, a person with diabetes can suffer a stroke anytime. People suffering from diabetes are also vulnerable to suffer from other conditions that can increase the risks of having heart disease and stroke.

The American Heart Association have indicated in their findings that 16 % of the adults above 65 years and with diabetes, die from a stroke and 68 % die from other heart diseases. They have also warned that diabetes is one of the seven controllable risk factors for various kinds of cardiovascular diseases.

How to reduce the occurrence of a stroke in people who have diabetes?

While stroke is a disease of the blood vessels, diabetes affects blood vessels in addition to other organs. So, if diabetes can be controlled, its timely control and other sorts of precaution can lessen the risks of a stroke resulting from it.

• People need to take proper medications to lower associated risks.
• A dietary change is also beneficial for the prevention of strokes.
• Exercising regularly, at least for 2 hours and 30 minutes is of great help.
• The diet should include lots of vegetables.
• Quitting smoking would be really great.
• Maintaining good cholesterol levels is a very important preventive measure.
• A healthy weight should also be maintained.

If you have any health queries related to Stroke Medicine, Geriatric Medicine, Neurological Diseases in the Elderly and General Medicine, and need medical advice/second opinion, contact us on  [email protected]

References:

• https://www.healthline.com/health/diabetes/diabetes-and-stroke
• https://www.webmd.com/diabetes/type-2-diabetes-guide/diabetes-stroke#1
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543806/

A stroke may be frightening to both the survivor and the family. Immediately after stroke it’s not unusual to feel overwhelmed, uncertain, about your newly added role as a caregiver. The common question that comes to the mind as a caregiver “Will My Loved Ones Recover from STROKE?”

Stroke recovery varies from person to person and is nearly impossible to predict. Some people can recover completely, some survivors require long-term care because of the severity of the impairments, some soon die after a stroke. Recovery from a stroke can vary from few days to months to years. It is determined by where in the brain the stroke occurred. For example, in which portion of the brain the stroke occurred. How much of the brain is affected, the survivor’s motivation, caregiver support, the quantity and quality of rehabilitation and the survivor’s health before the stroke.

What You Need To Know As a Caregiver

• Educate Yourselves:

1. • The first thing you should do as a caregiver is to ask questions for example What type of stroke did your loved one have? What side of the brain was affected? What caused the stroke? How can another stroke be prevented?
   • Build a network with other stroke survivors and caregivers.

• Avoid Falls: Falls after stroke is common. So, the first thing as a caregiver one should take into consideration is to make the home safer to avoid falls. For example, if there is a way the patient can avoid stairs, is there a way to put grab bars and seats in the bathroom and shower.

• Reduce the risks of having another stroke: Survivors are at a higher risk for a second stroke, so it’s important to help minimize that risk. Along with it, is also important to recognise the signs of Stroke.The risk of having another stroke goes up with the older age, high blood pressure, high cholesterol, diabetes, obesity, heart disease, cigarette smoking, use of alcohol and drug use. Though some of these risk factors cannot be controlled for example age, gender but some of these could be reduced through use of prescribed medicines by doctor or change of lifestyle.

• Focus on a healthy life style: After a stroke it is crucial to get all the nutrients your brain needs for a fast recovery from stroke. Neurogenesis helps to regenerate new cells and compensate for the damage from Stroke. It is crucial to have diet that is rich in neurogenesis for example blueberries, omega-3 fatty acids, green tea and curcumin. Along with proper diet, regular exercise, taking medicines on time as prescribed by the doctors and visits to the healthcare provider on time is crucial towards lowering the risk of having another stroke.

Stroke Complications That You Need To Be Aware Of

• Swallowing: Post Stroke, the survivor may have problem in swallowing. If the survivor face such problems, get some help from a speech therapist who can help you to relearn how to swallow and eat normally again. Dietitian can help you to find nutritious food that are easier to eat and swallow.

• Bladder And Bowel Control: Frequent urination, trouble urinating, ability to identify the need to go for urinating can be some of the problems a survivor may face. It is advisable to seek help from a bladder or bowel specialist if such problem persists.

• Be aware of the Physiological Problems A Stroke Patient May Face: Post Stroke, depression & anxiety are some of the common psychological problems noticed among the survivor. Signs of such emotions might interfere with your loved one’s recovery. In such cases, if you notice your loved one is having hard time controlling emotions, it is important to seek advice from your healthcare provider.

• Be aware of the Disrupted Cognitive Functions: One or more of the cognitive functions can be disrupted by a stroke. This includes communication, memory, and concentration, the ability to carry out skilled activities such as getting dressed or making a cup of tea. Though most of the communications skills can be recovered through speech and language therapy over time, but you may find that they don’t return to the way they were before.

The role of a caregiver can be stressful. So, as a caregiver it is important that you look after yourself. The more you look after yourself both physically and emotionally, the more you can care your loved ones. It is also crucial to take time for yourself. This shouldn’t be ignored. It contributes to your loved ones’ healing process.

If your loved ones had a stroke and you have questions about your loved ones recovery, it is best to ask a stroke specialist online

References:

• https://www.stroke.org/en/help-and-support/for-family-caregivers/15-things-caregivers-should-know-after-a-loved-one-has-had-a-stroke
• https://www.healthline.com/health/stroke/recovery#complications