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June 27, 2007Diabetes Care217 citationsOpen Access

Prospective Study of Type 1 and Type 2 Diabetes and Risk of Stroke Subtypes

MJMohsen JanghorbaniFHFrank B. HuWWWalter C. Willett

Key Points

  • To examine the relationship between type 1 and type 2 diabetes and the subsequent risk of total stroke and specific stroke subtypes in women.
  • Prospective cohort study following 116,316 women aged 30–55 years from 1976 through 2002, totaling 2.87 million person-years of follow-up.
  • Collected baseline and biennial questionnaire data regarding diabetes status, medical treatments, and stroke risk factors to identify incident stroke events.
  • During follow-up, 3,463 incident strokes occurred, with total stroke risk significantly elevated in type 1 diabetes (multivariate RR 4.7, 95% CI 3.3–6.6) and type 2 diabetes (multivariate RR 1.8, 95% CI 1.7–2.0).
  • Ischemic stroke risk was substantially increased in type 1 diabetes (RR 6.3, 95% CI 4.0–9.8) and type 2 diabetes (RR 2.3, 95% CI 2.0–2.6), with comparable risk estimates for large-artery infarction and lacunar stroke.
  • Type 1 diabetes was associated with a higher risk of hemorrhagic stroke (RR 3.8, 95% CI 1.2–11.8), whereas type 2 diabetes showed no significant association (RR 1.0, 95% CI 0.7–1.4).

Abstract

OBJECTIVE: The aim of this study was to examine the relationship between type 1 and type 2 diabetes and risk of stroke subtypes in women. RESEARCH DESIGN AND METHODS: We followed 116,316 women aged 30-55 years in 1976 through 2002 for incidence of stroke. At baseline and through biennial follow-up, women were asked about their history and treatment of diabetes and other potential risk factors for stroke. RESULTS: During 2.87 million person-years of follow-up, 3,463 incident strokes occurred. In multivariate analyses, the incidence of total stroke was fourfold higher in women with type 1 diabetes (relative risk RR 4.7 95% CI 3.3-6.6) and twofold higher among women with type 2 diabetes (1.8 1.7-2.0) than for nondiabetic women. The multivariate RR of ischemic stroke was increased sixfold (6.3 4.0-9.8) in type 1 diabetes and twofold (2.3 2.0-2.6) in type 2 diabetes. Risks for large-artery infarction and lacunar stroke were similar. Type 1 diabetes was also significantly associated with the risk of hemorrhagic stroke (3.8 1.2-11.8), but type 2 diabetes was not (1.0 0.7-1.4). CONCLUSIONS: Both type 1 and type 2 diabetes are associated with substantially increased risks of total and most subtypes of stroke.

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Cite This Study

Janghorbani et al. (2007) studied this question.

synapsesocial.com/papers/6a0c94cae28175e95a2369f4https://doi.org/10.2337/dc06-2363
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