Prevalence of diabetes mellitus in acute cerebrovascular events in regional Australia.

Abstract

Diabetes mellitus is a well-established independent and modifiable risk factor for both ischaemic and haemorrhagic strokes, increasing their risks by two to four folds. Previous studies have demonstrated a widely varying prevalence of known diabetes in acute stroke patients ranging from 17% to 49%, with higher prevalence observed in Asian populations. Locally, the 2014–15 National Survey identified the proportion of Australian population with diabetes as approximately 5%. To determine the prevalence of diabetes in patients admitted to Ballarat Base Hospital with diagnoses of acute strokes and transient ischaemic attacks in a 12-month period over 2015 (n¼155), a retrospective audit was conducted. Another aim is to determine if diabetes mellitus is more prevalent in certain ischaemic stroke subtypes. The results of neuroimaging, along with vascular imaging and cardiac testing were reviewed to ascertain the mechanisms of stroke. Details on patients with pre-existing diabetes as well as fasting glucose and/or HbA1c values were also recorded. The results of this study demonstrated that ischaemic stroke was more common than intracerebral haemorrhagic stroke, forming 82% of all acute strokes. Cardio-embolism was the primary aetiology of ischaemic strokes at 45.05%. The prevalence of diabetes in stroke in our study population (26.5%) is higher than the rates observed in other developed countries. The highest rate of diabetes was observed in lacunar strokes (31.25%). Hence, crucial evidence for physicians optimising primary and secondary stroke prevention may be derived given the significant rates observed in the abovementioned population.