AIM: To describe trends in first ischaemic stroke incidence and case fatality in adults with and without a diagnosis of Type 2 diabetes prior to their ischaemic stroke event in Scotland between 2004 and 2013.
METHODS: Using population-wide hospital admission, death and diabetes datasets, we conducted a retrospective cohort study. Negative binomial and logistic regression models were used to calculate year-specific incidence and case-fatality rates for people with Type 2 diabetes and for people without diabetes.
RESULTS: During 41.0 million person-years of follow-up there were 69 757 ischaemic stroke events. Type 2 diabetes prevalence among patients who experienced ischaemic stroke increased from 13.5% to 20.3% between 2004 and 2013. Stroke incidence rates declined by 2.7% (95% CI 2.4, 3.0) annually for people with and without diabetes [diabetes/year interaction: rate ratio 0.99 (95% CI 0.98, 1.01)]. Type 2 diabetes was associated with an increased risk of ischaemic stroke in men [rate ratio 1.23 (95% CI 1.17, 1.30)] and women [rate ratio 1.41 (95% CI 1.35, 1.48)]. Case-fatality rates were 14.2% and 12.7% in people with Type 2 diabetes and without diabetes, respectively. Case fatality declined by 3.5% (95% CI 2.7, 4.5) annually [diabetes/year interaction: odds ratio 1.01 (95% CI 0.98, 1.02)].
CONCLUSIONS: Ischaemic stroke incidence declined no faster in people with a diagnosis of Type 2 diabetes than in people without diabetes. Increasing prevalence of Type 2 diabetes among stroke patients may mean that declines in case fatality over time will be less marked in the future.
|Number of pages||8|
|Early online date||6 Nov 2017|
|Publication status||Published - Jan 2018|
|Event||Diabetes UK Professional Conference 2017 - Manchester, United Kingdom|
Duration: 8 Mar 2017 → 10 Mar 2017
Bibliographical noteFunding sources
Funding for this project came from a Chief Scientist Office post-doctoral fellowship. Funding for diabetes register linkage was provided by the Scottish Government. D.M. is funded via an Intermediate Clinical Fellowship from the Wellcome Trust (201492-Z-16-Z).
Aspects of the work presented in this manuscript have been presented at the Diabetes UK Professional Conference 2017 and at the European Diabetes Epidemiology Group Annual Meeting 2017.
Data Availability StatementAdditional Supporting Information may be found in the online version of this article
- Aged, 80 and over
- Brain Ischemia/complications
- Cohort Studies
- Diabetes Mellitus, Type 2/epidemiology
- Logistic Models
- Middle Aged
- Retrospective Studies
- Young Adult