I have had diabetes for more than 10 years (treated with Glucophage [metformin]) and recently I was hospitalized with a mild stroke. I experienced right hand weakness, had difficulty picking up things, can’t use typewriter, and almost everything that I need to do using my right hand is not possible. My blood pressure is normal, and I had normal scans. Was this caused by my diabetes?

Individuals with diabetes are predisposed to stroke in a manner similar to being predisposed to a heart attack. Diabetes is known to cause accelerated vascular changes in the blood vessels, including the brain. The stroke has affected your left side of your brain. A normal scan is not helpful when the stroke involves small but critical areas in the brain that control motor neurons. It is very common to have stroke associated with diabetes.

I am sorry you have experienced this stroke and sincerely hope you will recover function not yet realized. As part of your therapy, you will have to discuss with your physician whether you need a stronger anti-platelet drug than aspirin, a so-called aspirin failure regimen. This reference is used because most patients with diabetes are supposed to already be on aspirin as a prophylaxis to vascular disease and when stroke occurs while on this, the decision needs to be made about other drugs that might be more potent. In addition, make sure your lipids are checked and aggressively treated. Make sure your blood sugars are also in good shape with values as near normal as possible. Your blood pressure is good but will have to be watched.

JTL