Incident ischaemic stroke and Type 2 diabetes: trends in incidence and case fatality in Scotland 2004–2013

Read, S.H. et al. (2018) Incident ischaemic stroke and Type 2 diabetes: trends in incidence and case fatality in Scotland 2004–2013. Diabetic Medicine, 35(1), pp. 99-106. (doi:10.1111/dme.13528) (PMID:29044687)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lindsay, Dr Robert and McAllister, Dr David and Sattar, Professor Naveed
Authors: Read, S.H., McAllister, D.A., Colhoun, H.M., Farran, B., Fischbacher, C., Kerssens, J.J., Leese, G.P., Lindsay, R.S., McCrimmon, R.J., McGurnaghan, S., Philip, S., Sattar, N., and Wild, S.H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Diabetic Medicine
Publisher:Wiley
ISSN:0742-3071
ISSN (Online):1464-5491
Published Online:17 October 2017
Copyright Holders:Copyright © 2017 Diabetes UK
First Published:First published in Diabetic Medicine 35(1): 99-106
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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