Stroke and Diabetes
What Is the Treatment for Stroke?
One FDA-approved treatment for ischemic stroke is a clot-buster drug called tPA. This drug must be given within the first three hours after stroke symptoms begin. This drug dissolves the clot that has clogged an artery and can reestablish blood flow to brain tissue. This drug is not appropriate for all ischemic stroke patients, especially for those who've had major surgery in the previous two weeks or recent head trauma.
Also, there are several new and experimental drugs that may stop -- and even reverse -- brain damage if administered immediately after a stroke.
Options for inpatient stroke treatment include carotid endarterectomy, or surgical removal of the plaque from inside the carotid artery (the artery that supplies much of the blood to the brain). A less invasive treatment is a carotid angioplasty and stenting procedure, which may be appropriate for some patients who have blockages within the carotid arteries. This involves inserting a deflated balloon into the artery in order to expand the artery walls and then inserting a mesh structure (stent) to hold the artery open. This procedure may not be as effective, especially for those people with diabetes.
Angioplasty of the cerebral arteries can also be performed.
There are other ways to mechanically remove a blood clot in the brain. The FDA has approved the Merci Retrieval System and the Penumbra System for selected stroke victims. These devices can remove the blood clot after the stroke; however, improvement in stroke outcomes are uncertain.
How Can Stroke Be Prevented in Diabetes?
If you have diabetes and your doctor suspects that you have atherosclerosis (hardening of the arteries), he or she may suggest changes in diet and lifestyle, as well as certain medicines that may help to prevent the blockages that cause stroke. Other ways to reduce your risk of stroke include:
- Don't smoke.
- Keep your blood sugar levels controlled.
- Maintain a healthy weight.
- Exercise regularly.
- Have your cholesterol checked (especially your LDL, or "bad," cholesterol) and if necessary, lower your levels by limiting the amount of fat and cholesterol you eat. The target should be an LDL level of less than100 mg/dl (milligrams per deciliter). Some experts recommend even lower levels (less than 70 mg/dl) for those considered very high risk.
- Limit the amount of alcohol you drink. Guidelines are one drink per day for women and two drinks a day for men.
- Have your blood pressure checked and control your blood pressure, if necessary.
- Follow your health care provider's instructions for changing your diet.
- Follow your health care provider's instructions for taking preventive medicines.
- Take daily aspirin therapy* as prescribed by your doctor.