Living with diabetes can increase your risk of stroke and other heart and blood vessel conditions. While this doesn’t mean you will have a stroke, regular health checks, healthy lifestyle habits, and the right treatment can help reduce your risk. Registered Nurse and Credentialled Diabetes Educator, Carolien Koreneff, explains the key steps you can take to help prevent stroke.

What is a stroke?

A stroke happens when blood cannot reach part of the brain. Brain cells need oxygen and nutrients from blood. Without blood flow, brain cells can be damaged within minutes. There are three different types of stroke:

• Ischaemic stroke: This is the most common type. It happens when a clot blocks a blood vessel in the brain and part of the brain is starved of oxygen
• Haemorrhagic stroke: This happens when a blood vessel in the brain bursts, causing a haemorrhage, which is the medical term for a bleed. High blood pressure is a common cause
• Transient ischaemic attack (TIA): This is sometimes called a mini-stroke. If you have a TIA, stroke signs may go away quickly but it is still a medical emergency, as a TIA can be a warning sign that a stroke may happen soon

Why diabetes can raise stroke risk

Over time, glucose levels above your target range can damage blood vessels. Diabetes can also increase the chance of plaque building up inside blood vessels. Plaque is made from cholesterol, other blood fats, and other substances. It can narrow blood vessels and reduce blood flow. If plaque breaks, a clot can form and block blood flow to the brain.

Stroke risk can be higher if you also have blood pressure above your target range, high cholesterol, kidney disease, if you smoke (including vaping), if you have atrial fibrillation, a family history of heart or blood vessel conditions, or if your weight is affecting your health.

Know the signs: act F.A.S.T.

A stroke is an emergency. The F.A.S.T. test can help you act quickly.

• Face: Check the person’s face. Has their mouth drooped?
• Arms: Can they lift both arms?
• Speech: Is their speech slurred? Do they understand you?
• Time: If you see any of these signs, call 000 straight away

Other stroke signs can include sudden numbness or weakness on one side of the body, sudden trouble seeing, sudden dizziness or loss of balance, trouble swallowing, confusion, or a sudden severe headache. Do not wait to see if signs improve but get medical attention straight away.

How to lower your risk

The best plan is one that is personal to you. Ask your GP or diabetes care team about your heart and stroke risk, your targets, and what actions will help you the most.

• Keep blood glucose levels in your target range: Work with your diabetes team to set targets that are safe for you and review your plan regularly.
• Check blood pressure: Blood pressure above your target range is a major stroke risk. Have it checked regularly (every time you see the doctor) and take medicines as prescribed.
• Manage cholesterol: Ask your doctor if you benefit from taking cholesterol-lowering medicine. Many people living with diabetes benefit from treatment based on their overall heart and stroke risk.
• Do regular physical activity: Aim for about 30 minutes of moderate activity on most days, if this is safe for you. Add strength exercises two to three times a week if you can. Ask your GP for a referral to an exercise physiologist, so they can help you develop an exercise plan that fits in with your lifestyle and any physical issue you may have.
• Eat for heart health: Choose vegetables, fruit, wholegrains, legumes, nuts, seeds, fish, and unsaturated oils. Limit salt, saturated fat, processed meats, sugary drinks, and highly processed foods. Your GP can give you a referral to a dietitian who can assist you with a personalised healthy eating plan.
• Stop smoking: Quitting is one of the strongest ways to lower stroke and heart attack risk. Ask your GP, pharmacist, or call Quitline for support.
• Limit alcohol: If you drink alcohol, keep within Australian guidelines. Alcohol can affect your blood glucose levels or medicines. While there is no safe level of drinking, the guidelines help you stay healthy and protect yourself and your family from alcohol harm. It is generally recommended to drink no more than 10 standard drinks per week and no more than 4 standard drinks on any one day. Talk to your health professional for personalised advice.
• Take medicines as prescribed: Blood pressure, cholesterol, glucose-lowering, and blood-thinning medicines may lower risk for some people. Speak with your health professional before stopping or changing medicines.
• Keep your annual cycle of care up to date: Regular checks can find changes early and help prevent complications.

When to get help

Call 000 immediately if you notice any stroke signs, even if they are mild or go away. Quick treatment can save brain tissue and reduce long-term effects, including permanent disability.

Book an appointment with your GP or diabetes care team if you are unsure about your blood pressure, cholesterol, blood glucose targets, medicines, smoking, activity, food choices, or your overall heart and stroke risk.

Key message

People living with diabetes have a higher risk of stroke, but many risk factors can be reduced. The most important steps are to know the F.A.S.T. signs, call 000 for any stroke symptoms, and work with your health team to manage blood pressure, cholesterol, blood glucose levels, smoking, physical activity, food choices, and regular health checks.