Stroke awareness week runs from 31 August – 6 September 2020.

When you live with diabetes looking after your blood glucose levels can become your main health focus. However, many people forget that having diabetes can increase your chance of developing cardiovascular disease (CVD). CVD generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, stoke or chest pain.

Did you know when you are living with diabetes you be up to four times more likely to have a heart attack or stroke? This is because diabetes can change the chemical makeup of your blood, which may increase the development of atherosclerosis, which is the build-up of plaque (made up of cholesterol and other fats) in the arteries, causing blood vessels to narrow or to clog up completely.

What is a stroke?

Your brain is fed by blood carrying oxygen and nutrients through blood vessels called arteries, when blood cannot get to your brain, due to a block or burst artery, a stroke can happen.

There are two main types of stroke, both stop blood from getting to areas of the brain:

• Ischaemic stroke

This can occur when either an artery in the brain gets blocked by a clot that might be formed somewhere in the body (usually the heart). The clot then travels through the bloodstream to your brain. Or it may be due to the formation of plaque which can affect the major arteries in the neck which carry blood to the brain.

• Haemorrhagic stroke

This occurs when a blood vessel in the brain is ruptured, stopping the delivery of oxygen and nutrients. This is often be caused by high blood pressure.

How do you know if someone is having a stroke?

The Stroke Foundation recommends the F.A.S.T. test as an easy way to remember the most common signs of stroke, by asking these simple questions:

Face: Check their face. Has their mouth dropped?

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.

While arm weakness, facial weakness and difficulty with speech are the most common symptoms or signs of stroke, they are however not the only signs.

Other signs of stroke can also occur alone or in combination:

• Difficulty swallowing
• Dizziness, loss of balance or an unexplained fall
• Loss of vision, sudden blurring or decreased vision in one or both eyes
• Headache, usually severe and abrupt in onset
• Weakness or numbness or paralysis of the face, arm or leg on either side of the body.

Sometimes the signs disappear within a short time, such as a few minutes. This may be a transient ischaemic attack (TIA), which occurs when the blood supply to your brain is blocked temporarily. After a TIA, your risk of a stroke is higher and a warning that you may have a stroke.

Remember, if you or others experiences the signs of stroke, no matter how long they last, call 000 immediately.

What can you do?

When living with diabetes, you are more likely to have other health problems that can cause heart disease, such as high cholesterol and high blood pressure. This, along with having higher than ideal blood glucose levels, can damage the blood vessels, making them more likely to develop fat deposits. So looking after your heart health becomes extra important.

Look after your heart

Be physically active

Regular physical activity can lower blood pressure and help reduce the risk of a heart attack. Aim to do at least 30 minutes of moderate physical activity. Check with your doctor before starting exercise if you aren’t currently exercising.

Make healthy food choices

Follow a healthy diet with a wide variety of foods, such as fruits, vegetables, wholegrains, lean meat and low-fat dairy. It is also important to limit foods high in saturated fat and salt to reduce your risk of heart problems.

Keeping your blood fats (cholesterol and triglycerides) in check

Have regular blood test to ensure your cholesterol, triglycerides levels are in target range.

Manage high blood pressure

High blood pressure is common in people with diabetes, weight loss (if needed) and regular physical activity along with dietary changes such as reducing your salt intake, replacing unhealthy fats (saturated fats & trans fats) with healthy fats (unsaturated fats) and limit your alcohol intake can help reduce your risk of heart disease.

Maintain a healthy weight range

Carrying excess weight, especially around your waist not only increases insulin resistance but is a major risk factor for heart disease. Losing as little as 5-10% of your weight can reduce your risk of stroke.

If you smoke, try to quit

Smoking affects the vessels that supply blood to your heart and other parts of your body, it not only increases stiffness of those blood vessels making it harder to expand and contract, it also contributes to atherosclerosis, where it can narrow and clog your arteries. Smoking can increase your risk of having a stroke by three times.

Michelle Tong APD CDE