Stroke and diabetes mellitus.

Diabetes is a condition of accelerated vascular aging. Patients with diabetes have approximately twice the risk of stroke compared to nondiabetics. Hyperglycemia is a strong risk factor for poor outcome after stroke, but it may be simply a marker of poor outcome rather than a cause. Glucose lowering has not been shown to be associated with improved prognosis. Similarly, long-term prevention of stroke risk among diabetic patients is not improved with glucose-lowering therapies. Stroke prevention and treatment remains generic among diabetic patients. The future, however, may be brighter, with multiple new agents recently available. We await the outcome of these agents on macrovascular complications such as stroke.