Spotlight on stroke in type 2 diabetes: How the risk of these
devastating events can potentially be reduced
If you are living with type 2 diabetes, your doctor has probably
asked you to make healthy life choices to help lower your risk of
cardiovascular disease—and rightly so! If you have read this
article, you will know that if you have type 2 diabetes, your risk
of having a stroke or heart attack is up to four times greater
compared with someone without type 2 diabetes.
So, making changes in your lifestyle to promote your cardiovascular
health is really worth taking seriously. If you have read this blog
post, you will know of the connection between type 2 diabetes and
heart disease. This article will build on that knowledge to discuss
stroke as a cardiovascular disease. To find out more, read on.
Cardiovascular disease and where stroke comes into it
Let’s start with a recap on terminology: cardio means related to the
heart, vascular means related to the blood vessels.
The medical term for a stroke is a cerebrovascular accident. Cerebro
means related to the brain and we know that vascular means related to
the blood vessels. In this blog post, we want to explain why people
with type 2 diabetes are at increased risk of suffering a stroke and
what can be done to help prevent it from happening, including the role
that your diabetes medicine could play.
What happens during a stroke?
Although your brain is about 2% of your body weight, its intense
activity means that it consumes about 20% of the oxygen that enters
Oxygen reaches the brain through the blood, so to ensure normal
functioning of the brain, it’s important that its blood supply remains steady.
A stroke can have a significant effect on physical and mental
health—it can cause movement problems, pain, numbness, and problems
with thinking, remembering or speaking. Some people also experience
emotional problems, such as depression, after a stroke.
Unfortunately, when people with diabetes have a stroke, they are at
an increased risk of dying or being left with a long-term
disability, versus someone without diabetes.
Why does type 2 diabetes increase stroke risk?
post on heart disease explains that when there is damage to blood
vessels, fatty material (sometimes referred to as ‘plaque’) can build
up and obstruct the blood flow in a process known as atherosclerosis.
Atherosclerosis can build up for many years without you knowing—it is
a silent disease, and a stroke can happen suddenly, with no warning.
Uncontrolled blood sugar levels in people with diabetes damage the
walls of the blood vessels, thereby speeding up the process of
atherosclerosis. People with diabetes also tend to have high levels of
the types of fats in their blood that get turned into plaques.
High levels of sugar in the blood also make blood more likely to
stick together to form clots. When a clot reaches the brain, it can
lead to a stroke.
How your self-care helps lower your risk
Some risk factors for stroke can be kept in check by making your
lifestyle as healthy as possible. Here are some things that you can do:
Eat a healthy, balanced diet that is low in cholesterol and
Only drink alcohol within
Try to avoid
any excessive weight
You can read more about lifestyle changes promoting cardiovascular
health in this blog post.
Reducing your risk further with help from your diabetes doctor
You might already know about medicines that work to reduce certain
risk factors for cardiovascular diseases, like medicines that reduce
cholesterol or high blood pressure. If you haven’t had your
cholesterol or blood pressure checked in a while, why not make a note
to ask your doctor if it’s worth checking that they are under control?
As someone with type 2 diabetes, even if your diabetes and all of
your other risk factors for cardiovascular disease are
well-controlled, you may still, unfortunately, have a higher risk of
developing cardiovascular disease than the general population. Only 6%
of people with type 2 diabetes are thought to be managing this risk well.
Talk to your diabetes doctor to ensure you are on the right
treatment to help you manage your risks.
a guide to help you have a good conversation with your healthcare
provider about the current state of your type 2 diabetes with regards
to cardiovascular risks.
Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, et al.
Type 2 diabetes and cardiovascular disease: have all risk factors
the same strength? World J Diabetes 2014;5(4):444–470.
Lüscher TF, Creager MA, Beckman JA, Cosentino F. Diabetes and
vascular disease: pathophysiology, clinical consequences, and
medical therapy: Part ii. Circulation
Marso SP, Nauck MA, Monk Fries T, et
al. Myocardial infarction subtypes in patients with type 2 diabetes
mellitus and the effect of liraglutide therapy (from the LEADER
trial). Am J Cardiol 2018;121(12):1467–1470.
V, Langham MC, Wehrli FW. MRI estimation of global brain oxygen
consumption rate [published correction appears in J Cereb Blood
Flow Metab 2010;30(12):1987] [published correction appears in
J Cereb Blood Flow Metab 2011;31(5):1336]. J Cereb Blood
Flow Metab 2010;30(9):1598–1607.
Psychological Science. Myth: We Only Use 10% of Our Brains
[online] 29 August 2018. Available from:
[Last accessed: April 2021].
hypoxia [online]. Available from:
https://medlineplus.gov/ency/article/001435.htm [Last accessed:
American Diabetes Association. Stroke
[online]. Available from:
accessed: April 2021].
Kaarisalo MM, Räihä I, Sivenius J,
et al. Diabetes worsens the outcome of acute ischemic stroke.
Diabetes Res Clin Pract 2005;69(3):293–298.
National Heart, Lung and Blood Institute. Atherosclerosis
[online]. Available from:
accessed: April 2021].
Funk SD, Yurdagul A Jr, Orr AW.
Hyperglycemia and endothelial dysfunction in atherosclerosis:
lessons from type 1 diabetes. Int J Vasc Med
Dokken BB. The Pathophysiology of
Cardiovascular Disease and Diabetes: Beyond Blood Pressure and
Lipids. Diabetes Spectrum 2008;21(3):160–165.
Lemkes BA, Hermanides J, Devries JH, et al. Hyperglycemia: a
prothrombotic factor? J Thromb Haemost
Drenjančević-Perić I, Jelaković B,
Lombard J, et al. High-Salt Diet and Hypertension: Focus on the
Renin-Angiotensin System. Kidney Blood Press Res
Mukamal KJ, Chen CM, Rao SR, Breslow
RA. Alcohol Consumption and Cardiovascular Mortality Among U.S.
Adults, 1987 to 2002. J Am Coll Cardiol
Venkatasamy VV, Pericherla S,
Manthuruthil S, et al. Effect of Physical activity on Insulin
Resistance, Inflammation and Oxidative Stress in Diabetes Mellitus.
J Clin Diagn Res 2013;7(8):1764–1766.
Suarez-Ortegon MF, Read SH, et al. Risk Factor Control and
Cardiovascular Event Risk in People With Type 2 Diabetes in Primary
and Secondary Prevention Settings. Circulation
4 min. read
Type 2 diabetes – what's going on in your body?
Understanding the connection between insulin, blood sugar and
maintaining normal levels is important for controlling type 2 diabetes.
Is type 2 diabetes putting you at risk of heart disease?
If you have read this blog post, you will know of the connection between
type 2 diabetes and heart disease. A complete understanding of diabetes
is still lacking including cure for diabetes, but doctors know how to
manage diabetes effectively.