Patients with diabetes remain at greatly increased risk for ischemic stroke at all ages, but especially in the under-65 age group….
Lead investigator Jane C. Khoury, PhD, Cincinnati Children’s Hospital Medical Center, Ohio, stated that, "Our results suggest that diabetics aged under 65 have up to a 12-fold increased risk of stroke compared to people of a similar age who do not have diabetes." "In the over 65s, there was still an increase in stroke of about 2- to 3-fold in diabetic patients."
Dr. Khoury suggested that the reason for the larger increase in younger patients is that these individuals do not have as many other risk factors for stroke, so the presence of diabetes makes a big difference. "By the time patients get to their 70s, more other risk factors come into play so the individual effect of diabetes may not be so great," she added.
The data also suggest a race difference, with evidence of higher ischemic stroke risk in whites than blacks conferred by diabetes at almost all ages.
Noting that diabetes has previously been shown to be an important risk factor associated with poor post-stroke outcomes and disability, the researchers point out that the higher rates of stroke in patients with diabetes, especially in younger patients, may be associated with a higher burden of disability, productive life-years lost, and higher cost to society.
Dr. Khoury said her take-home message is: "We need to look out for patients susceptible to stroke and treat their risk factors. Our data show that diabetes is a very important preventable ischemic stroke risk factor. We need to make sure diabetics are well monitored, especially younger diabetics, and any other risk factors for stroke, such as hypertension, smoking, and AF [atrial fibrillation], are corrected in these patients. And this is another reason to be vigilant on diabetic control."
Published online Stroke, April 25, 2013