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.