Frequency of Prediabetes in Acute Stroke Patients Presenting at Tertiary Care Hospital, Karachi
DOI:
https://doi.org/10.70749/ijbr.v3i7.1832Keywords:
Prediabetes, acute stroke, ischemic stroke, dysglycemia, risk factors, tertiary care, KarachiAbstract
Background: Prediabetes, an intermediate state of abnormal glucose metabolism, is increasingly recognized as a risk factor for cardiovascular disease, including stroke. However, limited local data exist on its prevalence among acute stroke patients in Pakistan. Objective: To determine the frequency of prediabetes in patients presenting with acute stroke at a tertiary care hospital in Karachi. Methods: This cross-sectional study was conducted at a tertiary care hospital in Karachi. A total of 189 patients admitted with a diagnosis of acute stroke were included. Demographic data, clinical history, and laboratory findings were recorded. Prediabetes was defined random blood sugar 100 to 125 mg/dL. Data were analyzed using descriptive statistics and chi-square tests to identify associations between prediabetes and baseline variables. Results: Out of 189 patients, 53 (28%) were identified with prediabetes. Prediabetes was more frequent in the 40–60 years age group (43.1%) compared to older patients (20.2%) (p = 0.01). No significant association was found between prediabetes and gender (p = 0.29) or hypertension (p = 0.17). However, a statistically significant association was observed between prediabetes and dyslipidemia (p = 0.01). Smoking status also showed a marginal association with prediabetes (p = 0.05). Conclusion: A considerable proportion of acute stroke patients had prediabetes, particularly among middle-aged individuals. Routine screening for prediabetes in stroke patients may help identify at-risk individuals early and enable timely interventions to prevent diabetes and recurrent vascular events.
Downloads
References
1. Feigin VL. Stroke epidemiology in the developing world. Lancet 2005;365:2160-61.
https://doi.org/10.1016/s0140-6736(05)66755-4
2. Boehme AK, Esenwa C, Elkind MSV. Stroke risk factors, genetics, and prevention. Circ Res. 2017;120:472–95.
https://doi.org/10.1161/circresaha.116.308398
3. Giorda CB, Avogaro A, Maggini M, Lombardo F, Mannucci E, Turco S, et al. Incidence and risk factors for stroke in type 2 diabetic patients: the DAI study. Stroke. 2007;38:1154–60.
https://doi.org/10.1161/01.str.0000260100.71665.2f
4. Fonville S, Zandbergen AAM, Koudstaal PJ, den Hertog HM. Prediabetes in patients with stroke or transient ischemic attack: prevalence, Risk and Clinical Management. Cerebrovasc Dis. 2014;37:393–00.
https://doi.org/10.1159/000360810
5. Mijajlovic MD, Aleksic VM, Šternic NM, Mirkovic MM, Bornstein NM. Role of prediabetes in stroke. Neuropsychiatr Dis Treat. 2017;13:259–67.
https://doi.org/10.2147/ndt.s128807
6. DeFronzo RA, Abdul-Ghani M. Assessment and treatment of cardiovascular risk in prediabetes: impaired glucose tolerance and impaired fasting glucose. The American journal of cardiology. 2011 Aug 2;108(3):3B-24B.
https://doi.org/10.1016/j.amjcard.2011.03.013
7. Eguchi K, Boden-Albala B, Jin Z, Di Tullio MR, Rundek T, Rodriguez CJ, Homma S, Sacco RL. Usefulness of fasting blood glucose to predict vascular outcomes among individuals without diabetes mellitus (from the Northern Manhattan Study). The American journal of cardiology. 2007 Nov 1;100(9):1404-9.
https://doi.org/10.1016/j.amjcard.2007.06.032
8. Ford ES, Zhao G, Li C. Pre-diabetes and the risk for cardiovascular disease: a systematic review of the evidence. J Am Coll Cardiol. 2010;55(13):1310–17.
https://doi.org/10.1016/j.jacc.2009.10.060
9. Vermeer SE, Sandee W, Algra A, Koudstaal PJ, Kappelle LJ, Dippel DW, Dutch TIA Trial Study Group Impaired glucose tolerance increases stroke risk in nondiabetic patients with transient ischemic attack or minor ischemic stroke. Stroke. 2006;37(6):1413–17.
https://doi.org/10.1161/01.str.0000221766.73692.0b
10. Qiao Q, Pyörälä K, Pyörälä M, et al. Two hour glucose is a better risk predictor for incident coronary heart disease and cardiovascular mortality than fasting glucose. Eur Heart J. 2002;23(16):1267–75.
https://doi.org/10.1053/euhj.2001.3113
11. Lee M, Saver JL, Hong KS, Song S, Chang KH, Ovbiagele B. Effect of pre-diabetes on future risk of stroke: meta-analysis. BMJ. 2012;344:e3564.
https://doi.org/10.1136/bmj.e3564
12. Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ. 2016;355:i5953.
https://doi.org/10.1136/bmj.i5953
13. American Diabetes Association. Standards of medical care in diabetes—2023. Diabetes Care. 2023;46(Suppl 1):S1–S291.
14. Tanaka R, Ueno Y, Miyamoto N, Yamashiro K, Tanaka Y, Shimura H, et al. Impact of diabetes and prediabetes on prognosis in patients with acute ischemic stroke. J Neurol Sci. 2013;332(1-2):45–50.
https://doi.org/10.1016/j.jns.2013.06.010
15. O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376(9735):112–23.
https://doi.org/10.1016/s0140-6736(10)60834-3
16. Razzak MA, Kabir MH, Naznin F, Rahman QAA. Association between acute stroke and metabolic syndrome – an observational study. JAFMC Bangladesh. 2020;16(2):4–8.
https://doi.org/10.3329/jafmc.v16i2.55288
17. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(11 Suppl 1):S9–30.
https://doi.org/10.1210/jc.2008-1595
18. Joshi SR, Saboo B, Vadivale M, Dani SI, Mithal A, Kaul U, et al. Prevalence of diagnosed and undiagnosed diabetes and hypertension in India–results from the Screening India’s Twin Epidemic (SITE) study. Diabetes Technol Ther. 2012;14(1):8–15.
https://doi.org/10.1089/dia.2011.0243
19. Mohan V, Deepa R. Risk factors for coronary artery disease in Indians. J Assoc Physicians India. 2004;52:95–7.
20. Zahra F, Kidwai SS, Siddiqi SA, Khan RM. Frequency of newly diagnosed diabetes mellitus in acute ischaemic stroke patients. J Coll Physicians Surg Pak. 2012;22(4):226–9.
21. Amir A, Hassan M, Alvi S, Mueed A, Idrees S, Ashraf J, et al. Frequency and characteristics of metabolic syndrome in patients with ischemic stroke admitted to a tertiary care hospital in Karachi. Cureus. 2020;12(7):e9004.
https://doi.org/10.7759/cureus.9004
22. Mapoure YN, Ba H, Ayeah CM, Kenmegne C, Luma HN, Njamnshi AK. Acute stroke patients with newly diagnosed diabetes mellitus have poorer outcomes. J Stroke Cerebrovasc Dis. 2018;27(12):3657–65.
https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.04.017
23. Prabhakaran S, Chong JY. Risk factor management for stroke prevention. Neurol Clin. 2008;26(4):1001–17.
https://doi.org/10.1212/01.con.0000446102.82420.64
24. Sabanayagam C, Shankar A. Prehypertension and risk of cardiovascular disease: a meta-analysis. Am J Hypertens. 2007;20(7): 979–86.
25. Qiao Q. Comparison of different definitions of impaired glucose regulation in a Chinese population: the DECODE study. Diabet Med. 2003;20(5):364–71.
26. Thacker EL, Psaty BM, McKnight B, Heckbert SR, Longstreth WT Jr, Smith NL. Fasting and postload glucose concentrations and risk of ischemic stroke: the Cardiovascular Health Study. Stroke. 2011;42(10):2861–6.
https://doi.org/10.1161/strokeaha.111.620773
27. Knopman DS, Penman AD, Catellier DJ, Coker LH, Shibata DK, Sharrett AR, et al. Vascular risk factors and longitudinal changes on brain MRI. Neurology. 2011;76(22):1879–85.
https://doi.org/10.1212/wnl.0b013e31821d753f
28. DeFronzo RA, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care. 1991;14(3):173–94.
https://doi.org/10.2337/diacare.14.3.173
29. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research

This work is licensed under a Creative Commons Attribution 4.0 International License.