STROKE survivors with a higher genetic predisposition to Type 2 diabetes mellitus (T2DM) are more likely to experience poorer glycaemic control, according to a new study. This finding highlights the significant role of polygenic susceptibility to diabetes (PSD) in influencing health outcomes for patients with stroke, particularly in managing blood sugar levels.
The study, conducted in two stages, analysed data from stroke survivors in the UK Biobank and the All of Us research programme. Researchers evaluated the relationship between PSD and glycaemic control by categorising participants into low, intermediate, and high PSD groups based on percentiles of a polygenic risk score. This score incorporated 2,522 genetic variants associated with T2DM. Outcomes measured included haemoglobin A1c (HbA1c) levels, uncontrolled diabetes (HbA1c ≥7.0%), and resistant diabetes (uncontrolled despite antidiabetic treatment). In the first stage, involving 6,908 stroke survivors, those with high PSD showed a significant increase in HbA1c levels (β: 0.49, p-trend <0.001), 6.9 times higher odds of uncontrolled diabetes (OR: 6.92, 95% CI 4.71–10.52), and 7.8 times higher odds of resistant diabetes (OR: 7.76, 95% CI 4.92–12.89) compared to those with low PSD. These results were replicated in the second stage, which included 4,451 stroke survivors, further confirming the association between high PSD and poorer glycaemic control.
The findings underscore the importance of genetic risk assessment in clinical practice for stroke survivors, particularly those with or at risk of diabetes. Incorporating PSD into precision medicine strategies could improve glycaemic management and reduce adverse vascular outcomes in this population. Future research should explore targeted interventions and personalised treatment plans to address the unique challenges faced by stroke patients with high genetic susceptibility to T2DM. This approach could significantly enhance long-term recovery and quality of life for these individuals.
Katheeja Imani, EMJ
Reference
Demarais ZS et al. Polygenic susceptibility to diabetes and poor glycemic control in stroke survivors. Neurology. 2025;104(4):e210276.
