Recovery from stroke in patients with diabetes mellitus

Abstract

Background and Aim Diabetes mellitus (DM) is recognized as an important risk factor for stroke and might theoretically influence post-stroke level of disability, increasing the extension of the cerebral injured area. However, results of the few researches aimed at studying this influence are contradictory; moreover, the effect of DM on motor recovery has not been extensively studied. The aim of this study was to investigate the effect of DM on both functional and motor recovery. Methods A total of 395 acute patients with first stroke were selected in a rehabilitation department and divided into two groups on the basis of the presence or absence of DM (DM+ and DM−, respectively). Outcome measures were the Barthel Index, the Fugl-Meyer Assessment Scale, and the mobility part of the motor assessment chart according to Lindmark and Hamrin. Participants were assessed at admission to department (T1, 13.9±7.9 days from stroke onset), at discharge (T2, 40.1±13.4), and at follow-up (T3, 84.2±14.3). A 2×3 analysis of variance with repeated measures was performed to verify the effect of group and of phase of assessment on motor and functional measures and their interaction. Results DM+ and DM− groups included 93 and 302 patients, respectively. Both groups showed a significant and progressive improvement in all outcome measures ( P<.001), but no interaction was found between group and phase of assessment, which means that motor and functional recovery was similar in the two groups. Conclusion Results suggest that diabetes has no influence on motor and functional outcome within the acute and post-acute phase after stroke. Further research should investigate motor recovery in a longer-term period and with larger samples.