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Diabetes as a risk factor for stroke. A population perspective

B Stegmayr1, K Asplund

  • 1Department of Medicine, University Hospital, Umeå, Sweden.

Diabetologia
|September 1, 1995
PubMed
Summary

Diabetes significantly increases stroke risk and mortality in both men and women. Diabetic individuals face a substantially higher incidence and overall mortality from stroke compared to non-diabetic populations.

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Area of Science:

  • Epidemiology
  • Cardiovascular Medicine
  • Diabetology

Background:

  • Diabetes mellitus is a growing global health concern.
  • Cardiovascular complications, including stroke, are major causes of morbidity and mortality in diabetic patients.
  • Understanding the specific impact of diabetes on stroke incidence and outcomes is crucial for public health interventions.

Purpose of the Study:

  • To compare stroke incidence, case fatality, and mortality between diabetic and non-diabetic individuals in a defined population.
  • To assess the relative risk and population attributable risk of stroke associated with diabetes mellitus.
  • To identify comorbidities that are more prevalent in diabetic stroke patients.

Main Methods:

  • A population-based cohort study was conducted in northern Sweden (n=241,000) aged 35-74 years over an 8-year period.
  • Stroke events were recorded and compared between diabetic and non-diabetic subjects.
  • Statistical analyses included calculation of crude incidence, relative risks, 28-day case fatality, overall mortality, and population attributable risk.

Main Results:

  • Diabetic men had a 4.1-fold higher stroke incidence (1000/100,000) than non-diabetic men (247/100,000); diabetic women had a 5.8-fold higher incidence (757/100,000) than non-diabetic women (152/100,000).
  • 28-day case fatality was similar for men but significantly higher for diabetic women (22.2% vs 17.9%).
  • Overall stroke mortality was 4.4 times higher in diabetic men and 5.1 times higher in diabetic women. Comorbidities like hypertension and atrial fibrillation were more common in diabetic stroke patients. Population attributable risk was 18% for men and 22% for women.

Conclusions:

  • Diabetes mellitus is a significant independent risk factor for stroke, markedly increasing incidence and mortality.
  • Diabetic women experience a higher case fatality rate from stroke compared to non-diabetic women.
  • Public health strategies targeting diabetes management are essential to reduce the burden of stroke in the population.

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