Diabetes and stroke

The association between diabetes and stroke is well established. Recent large‐scale, international population studies suggest that diabetes is one of the most important modifiable risk factors for cerebrovascular disease. Despite this, we still have a relative paucity of evidence around the management of diabetes in stroke. The landscape is evolving and recent studies are helping establish best practice and suggesting new therapeutic opportunities. It is possible to develop a practical and clinical synthesis of the evidence around managing diabetes in adult patients with stroke and cerebrovascular disease, based on large trials, systematic reviews and guidelines, and focusing on the scenarios most often encountered in clinical practice. It is also important to recognise that there are common situations where robust evidence is lacking, but practical guidance for clinicians can be suggested

Long-term psychological outcomes following stroke: the OX-CHRONIC study

This is the final version. Available on open access from BMC via the DOI in this recordAvailability of data and materials: The dataset supporting the conclusions of this article is available in the study-specific Open Science Framework repository: osf.io/y2mevBACKGROUND: Stroke survivors rate longer-term (> 2 years) psychological recovery as their top priority, but data on how frequently psychological consequences occur is lacking. Prevalence of cognitive impairment, depression/anxiety, fatigue, apathy and related psychological outcomes, and whether rates are stable in long-term stroke, is unknown. METHODS: N = 105 long-term stroke survivors (M [SD] age = 72.92 [13.01]; M [SD] acute NIH Stroke Severity Score = 7.39 [6.25]; 59.0% Male; M [SD] years post-stroke = 4.57 [2.12]) were recruited (potential N = 208). Participants completed 3 remote assessments, including a comprehensive set of standardized cognitive neuropsychological tests comprising domains of memory, attention, language, and executive function, and questionnaires on emotional distress, fatigue, apathy and other psychological outcomes. Ninety participants were re-assessed one year later. Stability of outcomes was assessed by Cohen's d effect size estimates and percent Minimal Clinically Important Difference changes between time points. RESULTS: On the Montreal Cognitive Assessment 65.3% scored  2 years post-event exhibited psychological difficulties including domains of cognition, mood, and fatigue, which impact long-term quality of life. Stroke is a chronic condition with highly prevalent psychological needs, which require monitoring and intervention development.Stroke AssociationNational Institute for Health and Care Research (NIHR