Diabetes mellitus type 2 impedes functional recovery, neuroplasticity and quality of life after stroke

• Published in: Journal of family medicine and primary care Vol. 9; no. 2; pp. 1035 - 1041
• Main Authors: Chaturvedi, Poonam, Singh, Ajai, Tiwari, Vandana, Thacker, Anup
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.02.2020; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Cerebral edema; Coma; Comorbidity; Diabetes mellitus; Edema; functional recovery; Health; Medical research; neuroplasticity and quality of life; Original; stroke; Type 2 diabetes; type 2 diabetes mellitus; neuroplasticity and quality of life; type 2 diabetes mellitus; Functional recovery; stroke
• ISSN: 2249-4863; 2278-7135
• DOI: 10.4103/jfmpc.jfmpc_884_19

Objectives: The recovery after stroke depends on the resolution of brain edema and neuroplasticity. The comorbidities associated with stroke such as type 2 diabetes mellitus (T2DM) may increase the chances of unfavorable outcome and delay the recovery from stroke and needs further investigation. Subjects and Methods: The study dealt with 208 patients. The neurological status of the patients was assessed by Glasgow Coma Scale and the severity of stroke was assessed by the National Institute of Health Stroke Scale. Patients were divided into two groups: T2DM in group 1 and without T2DM in group 2. We assessed functional improvement by Functional Independence Measure (FIM) Scale, quality of life by Stroke Specific Quality of Life (SSQOL) Scale, and serum levels of brain-derived neurotrophic factor (BDNF) for assessing neuroplasticity. Results: We observed lower levels of BDNF in diabetic stroke patients. There was significant improvement in FIM scale scores and SSQOL scale scores in non-diabetic stroke patients after 6 months (P < 0.05). The relative risk (RR) of poor functional recovery (FIM) in the diabetic group was 1.34 [95% confidence interval (CI) 1.0-1.8] and the odds ratio (OR) was 1.8 (95% CI 1.03-3.12). Diabetes is an independent risk factor for poor BDNF recovery (serum BDNF < mean value, i.e. 10.07 ± 3.8 ng/mL) (RR 2.40; 95% CI: 1.36-4.21 and OR 1.6; 95% CI: 1.15-2.13] and poor quality of life (RR 1.56; 95% CI: 1.13-2.16 and OR 2.83; 95% CI: 1.14-7.0). Conclusion: Diabetes is not only a risk factor for stroke occurrence but also delayed recovery after stroke.