Diabetes increases long-term post-stroke mortality

1 August 2008

MedWire News: Diabetes decreases the long-term survival chances of post-ischemic stroke patients, study findings suggest.

Masoor Kamalesh and colleagues from Indiana University in Indianapolis, USA, investigated the associations between diabetes prevalence and post-stroke mortality in more than 49,000 predominantly male (98%) US veterans who were treated for stroke between 1990 and 1998.

The team found a higher proportion of diabetics among the stroke patients, compared with data for the general public. Age correlated with diabetes prevalence, with the lowest rate occurring in the <50 years group and highest rate in the >65 years group.

Diabetes patients, who comprised 28% of the overall study population, had significantly more chronic conditions than patients without diabetes, including hypertension (67.9% vs 53.9%), coronary artery disease (21.5% vs 15.7%), congestive heart failure (8.8% vs 6.4%), and hyperlipidemia (10.1% vs 7.2%).

Diabetic patients had significantly higher numbers of discharge diagnoses and cardiovascular re-admissions than nondiabetic stroke patients, suggesting they had a higher risk for death.

Despite this, there was no significant difference between post-ischemic stroke mortality after 60 days and 1 year between the two groups. However diabetic patients had a shorter long-term survival period.

Overall, diabetic patients had a 15% higher mortality risk than nondiabetics. This multivariate analysis was based on age, gender, ethnicity, chronic conditions, co-morbidities, hospitalization, and region.

The researchers note that progressive atherosclerotic cardiovascular disease is thought to be the key catalyst of reduced long-term mortality in diabetic patients.

"Prevention and control of diabetes will be of paramount importance if its contribution to stroke is to be reduced," Kamalesh and team conclude in the journal Stroke.

Stroke 2008; Advance online publication