DOC News June 1, 2007
Volume 4 Number 6 p. 20
© 2007 American Diabetes Association
Risks of Stroke in Type 2 Diabetes
Age and a history of stroke are strong predictors of the risk of future
strokes among people with diabetes, according to a new analysis.
Type 2 diabetes is recognized as a risk factor for cerebrovascular disease.
But comparatively little is known about the incidence and risk factors of
stroke among diverse people with diabetes. A team of researchers at the
Italy-based Diabetes and Informatics study group analyzed >14,000 people
40–97 years old with type 2 diabetes and no history of cardiovascular
disease. The researchers followed participants for 4 years.
There were 296 strokes documented during the follow-up period, for an
overall rate of 5.5 cases per 1,000 person-years among men and 6.3 cases per
1,000 person-years among women. The risk of stroke varied according to age,
sex, and history of cardiovascular disease (CVD). A history of stroke strongly
predicted stroke in both sexes.
Among men with a CVD history, prominent risk factors for repeat stroke
included therapy with insulin with oral agents and treated high total
cholesterol and low HDL cholesterol. Among women with a CVD history,
microvascular complications were noted as a risk factor for stroke. Among
patients with no CVD history, risk factors for stroke include high glycated
hemoglobin (A1C) and smoking.
While age and previous stroke are the main factors raising the risk of
stroke, the combined effect of high A1C, microvascular complications, low HDL
cholesterol, and the presence of antidiabetic drug therapy that serves as a
surrogate marker of disease severity "highlights the importance of
diabetic history and clinical background in the development of stroke,"
the researchers conclude.
Giorda CB, Avogaro A, Maggini M, et al.: Incidence and risk
factors for stroke in type 2 diabetic patients: The DIA study.
Stroke 38:1154–1160, 2007.[Abstract/Free Full Text]
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