Diabetes can increase your risk for many health conditions, including stroke.

People with diabetes are twice as likely to have a stroke as people without diabetes, according to the American Stroke Association. They’re also more likely to have a stroke at an earlier age, and the outcome may be worse.

If you have prediabetes, you already have a higher risk of heart disease and stroke than people without diabetes.

Diabetes affects the body’s ability to create insulin or use it properly. Since insulin plays an important role in pulling glucose into cells from the bloodstream, people with diabetes often have too much sugar in their blood.

Over time, this excess sugar can contribute to the buildup of clots or fat deposits inside vessels that supply blood to the neck and brain. This process is known as atherosclerosis.

If these deposits grow, they can cause a narrowing of the blood vessel wall or even a complete blockage. Any interruption to the blood supply in the brain will stop blood and oxygen from reaching brain cells.

This can lead to a stroke. Without rapid treatment, a stroke can result in permanent cell damage or death.

A stroke can also result if bleeding occurs in the brain.

The main types of stroke are:

Ischemic stroke

Ischemic stroke is the most common type of stroke. It occurs when an artery that supplies oxygen-rich blood to the brain is blocked, most often by a blood clot.

About 87% of strokes are ischemic strokes, according to the Centers for Disease Control and Prevention.

Hemorrhagic stroke

Hemorrhagic stroke occurs when an artery in the brain leaks blood or ruptures. Around 10% to 20% of strokes are hemorrhagic strokes.

The risk of severe complications or death is higher than with an ischemic stroke. People with diabetes have a higher risk of small bleeds in the brain, known as cerebral microbleeds.

Transient ischemic attack (TIA)

A TIA is sometimes called a ministroke because the blood flow to the brain is blocked for a shorter amount of time and doesn’t result in permanent neurological injury.

A TIA is a type of ischemic stroke. It may last from a minute to several hours — until the clogged artery reopens on its own.

People often refer to a TIA as a “warning stroke.” Around 15% of people who have a stroke have previously had a TIA. If you think someone has had or is having a TIA, seek help at once.

Recognizing the signs and symptoms of a stroke is a crucial first step to getting help. Early help can lower the risk of severe complications.

Other symptoms that can signal a stroke include sudden:

  • numbness or weakness of the face or the arms and legs, usually on one side
  • confusion
  • trouble understanding speech
  • difficulty seeing in one or both eyes
  • dizziness
  • a loss of balance or coordination
  • trouble walking
  • a severe headache for no known reason

If you think you’re experiencing a stroke, call 911 or your local emergency services immediately. A stroke is a life threatening condition.

If you think someone is having a stroke, take action FAST

To help people remember how to recognize a stroke, the American Stroke Association endorses the mnemonic FAST, which stands for:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911 or your local emergency services

Treatment will depend on the type of stroke.

Ischemic stroke

Treatment for an ischemic stroke includes:

  • clot-busting drugs to reduce or remove the blockage
  • drugs to thin the blood, such as aspirin
  • treatment to prevent seizures, if necessary
  • surgery, in some cases, to remove a blockage or insert a stent
  • exercises and therapy to help restore any lost function, such as speech or movement

Hemorrhagic stroke

Treatment for a stroke that results from bleeding in the brain will involve:

  • managing blood pressure, including raised blood pressure in the brain
  • using coagulant drugs to slow the bleeding
  • treatment for epilepsy, if seizures occur
  • surgery, in some cases
  • follow up nursing care and rehabilitation, as needed

TIA

There is no specific treatment for a TIA, but doctors will recommend measures to lower the risk of a stroke. This is essential because 20% of people who have a TIA go on to have a stroke within 3 months. Around half of these happen in the 2 days after the TIA.

Options include:

  • monitoring the person’s risk
  • antiplatelet therapy or statins to reduce the risk of clotting
  • diet and exercise
  • measures to manage blood pressure
  • surgery, in some cases

The risk factors for stroke include:

Many people with diabetes have another condition, such as obesity or cardiovascular problems. These further increase the risk.

Lifestyle risk factors include:

The risk is also higher for Black and Hispanic Americans, research suggests. Socioeconomic factors, such as reduced access to health insurance and education, may play a role.

It’s not always possible to avoid a stroke, but some actions can help reduce the risk.

Here are some tips:

  • Attend all appointments, and follow your treatment plan for diabetes management.
  • Seek help for other stroke risk factors, such as obesity, hypertension, and high cholesterol.
  • Limit alcohol consumption.
  • Quit or avoid smoking.
  • Maintain a diabetes-friendly diet.
  • Do regular exercise.

Dietary options

High blood pressure and high cholesterol can increase your risk of stroke. You might be able to reduce your blood pressure and cholesterol levels by making changes to your diet.

Try the following tips:

Exercise

Doing moderate-intensity exercise for 2 hours and 30 minutes per week can help reduce your risk of stroke and other diseases.

Examples of exercises that get your body moving are:

  • a brisk, daily walk
  • swimming
  • gardening
  • cycling

Quit smoking, if you smoke

If you smoke, ask a doctor about smoking cessation programs or other things you can do to help you quit smoking. People who smoke have a higher risk of stroke than those who don’t smoke.

Limit how much alcohol you drink

If you drink alcohol, try to limit your intake to no more than two drinks per day for males or one per day for females.

Take your medication as prescribed

Some medications help reduce the risk of a stroke.

These include:

  • blood pressure medications
  • diabetes medications
  • cholesterol medications (statins)
  • medications to prevent blood clots, such as aspirin and blood thinners

If a doctor prescribes these medications, be sure to take them as they recommend.

Factors affecting the outlook include:

  • the type of stroke
  • the extent of any damage
  • which part of the brain is affected
  • the taken before accessing treatment
  • other health conditions the person has
  • the type of rehabilitation you have as follow-up

People who can get to the emergency room within 3 hours of symptoms starting are less likely to have severe consequences than those who receive later treatment, according to the CDC.

If a person has a TIA, they may not have any adverse effects, although there’s a 20% risk of having another stroke within 3 months.

An ischemic or hemorrhagic stroke can be life threatening. If the person survives, they may experience long-term problems with various functions, including:

  • movement
  • thinking and reasoning
  • speech and language

Statistics suggest that in high-income countries, such as the United States, an ischemic stroke is fatal within 30 days in around 15% of cases overall.

Around 25% to 30% of hemorrhagic strokes are fatal in high-income countries, such as the United States, but this figure can rise to 48% in some countries.

The complications of a hemorrhagic stroke include seizures and ongoing problems with the brain, lungs, and cardiovascular system.

Anyone who appears to be having a stroke needs immediate medical assistance. It’s essential to call 911 or seek emergency medical services as soon as possible.

Why does diabetes increase the risk of a stroke?

High blood sugar levels increase the chance of fatty deposits or clots developing in the blood vessels. These can block the flow of blood and prevent oxygen from reaching the brain.

People with diabetes also have a higher risk of small bleeds in the brain, which could lead to a hemorrhagic stroke.

What are the symptoms of a diabetic stroke?

The symptoms of a diabetic stroke are the same as for any stroke. They include problems with speech, a sudden and severe headache, weakness or numbness on one side of the body, confusion, dizziness, loss of balance, and vision problems.

Can low blood sugar cause symptoms like a stroke?

Hypoglycemia is when blood glucose levels are below 70 milligrams per deciliter. It’s potentially life threatening and can affect people with diabetes who are using insulin.

Symptoms include confusion, a loss of consciousness, and seizures. It can also cause paralysis and speech problems. These symptoms can resemble those of a stroke.

People with diabetes have a higher risk of a stroke than those without. Also, they’re more likely to have a stroke at a younger age, and the outcome may be more severe.

If you have diabetes, one way of lowering your risk of a stroke is to follow any treatment plan for managing blood sugar levels.

People with diabetes can also take the same steps as those without diabetes, such as avoiding smoking, limiting alcohol intake, and getting regular exercise.