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Abstract
Background: Recurrent ischemic stroke remains a major cause of long-term disability and mortality, particularly among individuals with uncontrolled diabetes mellitus.
Objective: This study aimed to determine the frequency of recurrent ischemic stroke in patients with uncontrolled diabetes and to evaluate associated clinical factors.
Methods: This cross-sectional study was conducted in the Department of General Medicine, KEMU/Mayo Hospital, Lahore, from January 2025 to May 2025, including 120 patients aged 30–80 years with uncontrolled diabetes for more than one year. Non-probability consecutive sampling was used. Patients were followed for three months, and recurrent ischemic stroke was diagnosed based on clinical presentation and CT imaging.
Results: The mean age of the study population was 58.6 ± 10.4 years, and 64.2% were male. Recurrent ischemic stroke occurred in 23 out of 120 patients (19.2%). Higher recurrence was observed in older individuals (mean age 62.4 ± 9.1 years) and those with diabetes duration >10 years (recurrent: 56.5% vs non-recurrent: 32.0%). Uncontrolled hypertension (78.3% vs 53.6%, p = 0.03), carotid artery stenosis >50% (39.1% vs 12.4%, p = 0.004), and poor medication adherence (65.2% vs 35.1%, p = 0.01) were significantly associated with recurrence. CT imaging showed new infarcts in 100% of recurrent cases and chronic infarcts in 47.8%.
Conclusion: Recurrent ischemic stroke was identified in nearly one-fifth of patients with uncontrolled diabetes. Older age, long-standing diabetes, uncontrolled hypertension, carotid stenosis, and poor adherence to medications were key predictors of recurrence.