Table 1.

Main studies that have evaluated the association between diabetes (or diabetic foot syndrome) and stroke (or preclinical conditions of increased stroke risk).

Main Author	Study Design	Results	Ref.
Framingham study	Cohort study. 20 years of cohort surveillance	2.5-fold incidence of ischemic stroke in diabetic men and a 3.6-fold one in diabetic women.	[74]
Tuttolomondo	Case-control prospective study	Diabetes was associated with lacunar ischemic stroke subtype, with a record of hypertension, and a better Scandinavian Stroke Scale score at admission. The association of diabetes with lacunar stroke remained significant even after adjustment for hypertension or large artery atherosclerotic and cardioembolic stroke subtypes.	[77]
Karapanayiotides	Case-control study	Diabetes was associated with a higher relative frequency of small-vessel and large-artery disease, a lower relative prevalence of intracerebral hemorrhage, a higher relative prevalence of subcortical infarction.	[90]
Manolio	Prospective study	Odds ratio (OR) of 2.12 in those who have diabetes after an adjustment for other risk factors.	[93]
Giles	Prospective study	Odds ratio (OR) of 2.47 in those who have diabetes after an adjustment for other risk factors.	[94]
Megherbi	Prospective study	Diabetic patients, compared with those without diabetes, were more likely to have limb weakness, dysarthria, ischemic stroke, and lacunar cerebral infarction.	[95]
Larsson	Mendelian randomization (MR) analysis	MR analysis showed associations between genetically predicted T2D (type 2 mellitus diabetes) and large artery stroke (OR 1.28) and small vessel stroke (OR 1.21) but not cardioembolic stroke.	[96]
Roper	Longitudinal, population-based study	All-cause standardized mortality ratios for type 2 diabetes were 160 (147 to 174) in women and 141 (130 to 152) in men. Cause-specific standardized mortality ratios were increased for ischemic heart disease, cerebrovascular disease, and renal disease.	[97]
Pinto	Case-control prospective study	Higher prevalence of major cardiovascular risk factors (such as dyslipidemia), of asymptomatic markers of cardiovascular disease (CVD), and a higher prevalence and incidence of previous and new-onset vascular events (coronary artery disease, transient ischemic attack/ischemic stroke, diabetic retinopathy) in diabetic patients with foot complications.	[98]
Tuttolomondo	Case-control study	Patients with DFS (diabetic foot syndrome) showed higher mean values of PWV (pulse wave velocity), lower mean values of RHI (reactive hyperemia index), and lower mean MMSE (mini-mental state examination).	[99]
Tuttolomondo	Case-control study	DFS patients show a higher degree of activation of the parasympathetic system than diabetic controls and a higher degree of vascular impairment, as indicated by lower RHI values.	[100]