The Role of Diabetes Mellitus in the Severity of Ischemic Stroke: An Inpatient Study

Abstract

Background: Diabetes mellitus (DM) is recognized as an important risk factor associated with ischemic stroke and unfavorable clinical outcomes. Persistent hyperglycemia and vascular dysfunction may contribute to increased neurological impairment among stroke patients. However, evidence regarding the relationship between DM and ischemic stroke severity in hospitalized patients in Indonesia remains limited. Objective: This study aimed to determine the association between diabetes mellitus and the severity of ischemic stroke among hospitalized patients. Methods: A cross-sectional observational study was conducted using retrospective medical record data from patients diagnosed with acute ischemic stroke at Jemursari Islamic Hospital Surabaya between January and April 2025. Diabetes mellitus status was identified from documented diagnosis, antidiabetic treatment history, or laboratory findings. Stroke severity was evaluated using the Modified Rankin Scale (mRS) and categorized into mild (mRS 1–2), moderate (mRS 3), and severe disability (mRS 4–5). Statistical analysis was performed using the Chi-square test, and the association strength was expressed as odds ratio (OR) with a 95% confidence interval (CI). Results: A total of 46 patients were included in the study. Most participants presented with moderate-to-severe functional disability. Diabetes mellitus showed a significant association with ischemic stroke severity (p < 0.05). Patients with DM had a greater likelihood of developing moderate-to-severe stroke compared with non-diabetic patients (OR = 3.2; 95% CI: 1.1–9.4). Conclusion: Diabetes mellitus was significantly associated with increased severity of ischemic stroke among hospitalized patients. These findings emphasize the importance of early identification and optimal glycemic management to reduce severe neurological and functional outcomes in ischemic stroke patients.