People with diabetes have a higher risk of stroke than those without it. But a person can reduce their stroke risk by controlling their diabetes well and making certain lifestyle changes.

For an individual with diabetes, the chances of having a stroke are 1.5 times higher than in people who do not have the disease, according to the American Diabetes Association. This is because frequent shifts in blood sugar levels can affect the cardiovascular system. This article discusses the link between diabetes and stroke. It also looks at ways of preventing or lowering the risk of a stroke.

What is the link?

A stroke occurs when the blood supply to the brain is interrupted. Most strokes result from a blood clot blocking a blood vessel in the brain or neck. Over time, high blood sugar levels can damage blood vessels and nerves. People with diabetes have longer periods of high blood sugar than those without diabetes, especially if the condition is not well-controlled. This makes a person with diabetes more likely to have a stroke. People with diabetes are also more likely to have other conditions that increase the risk of heart disease and stroke, such as high blood pressure and obesity.

The American Heart Association (AHA) reports that 16% of adults over the age of 65 with diabetes die from a stroke and that 68% die from some form of heart disease. According to their website, the AHA considers diabetes to be "one of the seven major controllable risk factors for cardiovascular disease," a list that also includes obesity, high blood pressure, an unhealthful diet, and smoking cigarettes.

What to know about stroke

A stroke occurs when blood flow is blocked to an area of the brain, due to either a clot or a ruptured blood vessel. When this happens, brain cells in the area are deprived of oxygen and nutrients, causing cell tissue death and, in some cases, brain damage. There are three types of stroke:

• An ischemic stroke results from a clot blocking blood flow to the brain
• A hemorrhagic stroke results from a burst blood vessel or a leak from a weakened blood vessel
• A transient ischemic attack (TIA), previously known as a mini-stroke, results from temporary blood clots or low blood flow to the brain

Symptoms and warning signs

Stroke symptoms and warning signs typically develop suddenly. Many healthcare providers urge people with an increased stroke risk to learn the F.A.S.T. warning signs and action plan. F.A.S.T. stands for the following:

• Facial drooping on one side
• Arm weakness or one arm drifting downward when both arms are raised
• Speech problems, such as slurred speech
• Time to call 911

Beyond the F.A.S.T. indicators, there are other symptoms of a stroke:

• Numbness or weakness in one side of the face or body
• A severe headache
• Trouble walking and other coordination and balance problems
• Confusion
• Trouble seeing in one or both eyes

These symptoms tend to come on suddenly and can be severe. Some symptoms vary between males and females. Learn about the warning signs of stroke in males here.

Risk factors

Along with diabetes, there are other health problems that can increase a person's stroke risk:

• High blood pressure
• Obesity
• High cholesterol
• A history of heart disease
• A previous stroke, including a TIA
• Sickle cell disease
• Bleeding disorders
• Depression

According to the Centers for Disease Control and Protection (CDC), stroke is more common in certain groups:

• Older adults, with the chances of a stroke doubling every 10 years after the age of 55
• Males, though females are more likely to die from a stroke
• African-Americans, with the risk of a first-time stroke being almost twice as high as it is for white people in the country
• Hispanic people, American Indians, and Alaska Natives, compared with white people in the country
• People with a family history of stroke

Additionally, lifestyle factors can increase a person's risk of stroke, including smoking cigarettes, using alcohol or illicit drugs, and not getting regular exercise.

Prevention

Some people need to take medications to lower their risk of stroke. For others, managing their diabetes and maintaining a heart-healthy lifestyle is enough to reduce this risk. People with diabetes can control their blood sugar levels by paying attention to their diet and taking other steps to prevent these levels from spiking. The American Diabetes Association's current guidelines recommend that people follow an individualized diet plan, usually developed with the help of a dietitian or nutritionist, to manage their blood sugar levels. Some ways to reduce the risk of a stroke include the following:

• Exercise regularly, getting at least 2 hours and 30 minutes of moderate-intensity exercise per week, which can include brisk walks
• Have a diet that includes lots of vegetables and little unhealthy cholesterol
• Quit smoking
• Use moderation when drinking alcohol
• Maintain good cholesterol levels
• Maintain a healthy weight
• Treat high blood pressure

Recovery

Stroke recovery is different for everyone. Some people make a full recovery from a stroke in a matter of weeks. For others, it can take years, and some people never fully recover. Recovery largely depends on how quickly and effectively a doctor administers treatment. If a person receives emergency stroke treatment quickly, they are more likely to have a better outcome. Emergency stroke treatment varies, based on the type of stroke, but it can include the following:

• Clot-busting drugs
• Endovascular procedures to remove any blockages
• Surgical stenting procedures
• Surgical blood vessel repair

After a stroke, there are often some lingering effects:

• One-sided weakness or paralysis
• Trouble speaking or understanding speech
• Difficulty expressing emotions
• Balance and coordination problems
• Difficulty controlling the bladder or bowels
• Trouble eating and swallowing
• Depression

A person who has had a stroke may need rehabilitation, depending on their experience. Some potential elements of rehab include:

• Physical therapy to help with balance, coordination, and weakness
• Occupational therapy to make daily tasks easier
• Speech therapy to help a person relearn how to speak and understand speech

Outlook

A person with diabetes is more likely to have a stroke than a person without the disease. Strokes are the fifth leading cause of death in the United States and the leading cause of disability. Some people make a full recovery after a stroke, while others have lasting symptoms. Fast treatment reduces the risk of long-term complications. People can take steps to prevent a stroke by maintaining a healthful lifestyle and managing risk factors, including controlling diabetes symptoms, eating a varied, nutritious diet, and getting regular exercise.