Autonomic Neuropathy Predicts the Development of Stroke in Patients With Non-Insulin-Dependent Diabetes Mellitus

BACKGROUND AND PURPOSE: Our aim was to determine the predictive factors for stroke in patients with non-insulin-dependent diabetes mellitus (NIDDM). METHODS: We studied 133 patients with NIDDM at the time of diagnosis and 5 and 10 years later. RESULTS: The number of new fatal or nonfatal strokes was 19 (14.7%; 14 after 5-year examination). High initial fasting blood glucose (odds ratio OR, 1.2; 95% confidence interval CI, 1.04 to 1.4) and the use of beta-blocking agents (OR, 6.7; 95% CI, 2.1 to 21.5) at baseline and the presence of parasympathetic neuropathy (OR, 6.7; 95% CI, 1.5 to 29.9), or sympathetic autonomic nervous dysfunction (OR, 1.1; 95% CI, 1.01 to 1.2), hypertriglyceridemia (OR, 5.7; 95% CI, 1.1 to 31.0), or use of beta-blocking agents (OR, 6.4; 95% CI, 1.3 to 31.2), and high fasting plasma glucose (OR, 1.2; 95% CI, 1.0 to 1.5) determined at 5-year examination predicted the development of stroke. CONCLUSIONS: Autonomic neuropathy is an independent risk factor for stroke in NIDDM.