Stroke

This is a devasting complication of Diabetes which has tremendous impact on the lives of Diabetics and their families. Stroke may cause permanent disabilities and even death. Such patients are often paralyzed and unable to move, walk normally, speak, comprehend, have dementia or psychiatric illnesses.

Cells of brain do not have any reserves of energy of their own, they depend on fresh supply of oxygenated arterial blood for these, If the blood supply is disrupted even for few minutes brain cells die and the function controlled by them is lost.

Stroke is caused by disruption of blood supply to areas of the brain, either due to a clot obstructing the narrowed path of the arteries - called 'Thromboembolic Stroke', or due to bleeding from any of the small or large arteries supplying blood to brain- called 'Hemmorhagic Stroke'. Diabetes is a hypercoaguable state, blood clots form more easily and even when they are not required- leading to blockage of arteries. Due to atherosclerosis arteries supplying the brain may themselves be narrowed and tend to block more easily. Stroke may be preceded by so called Transient Ischemic Attack or TIA, which is a forewarning of an incumbent stroke due to a small thrombus blocking an artery but getting dissolved subsequently. The symsptoms of TIA may be similar to those of a stroke but milder and transiet, resulting in prompt recovery.

Symptoms  of TIA or Stroke:

• Slurring of speech

• Sudden onset numbness or weakness in a part of the body or half of the body

• Unable to speak, understand

• Sudden irrational behaviour

• Seizures or coma

Stroke is an Acute Emergency- any person suspected to be suffering from a stroke should be immediately rushed to a specialized Hospital where facilities for management of such patients are available. There are some treatments available for acute stroke but they have to be administered in a short period of time preferably less than 3 hours after the onset of stroke to give maximum benefit.

High Blood glucose levels during or after stroke may cause another acute complication of Diabetes- Hyperosmolar Hyperglycemic Syndrome, which may further complicate management of stroke.