Increased Ischemic, Hemorrhagic Stroke Risks in Type 1 Diabetes

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Poor glycemic control increases stroke risk in patients with type 1 diabetes.
Poor glycemic control increases stroke risk in patients with type 1 diabetes.

HealthDay News – The risks of ischemic and hemorrhagic stroke are increased with type 1 diabetes, with incrementally increasing risks with increasing hemoglobin A1c (HbA1c), according to a study published in the Journal of Internal Medicine.

Christina Hedén Ståhl, from the University of Gothenburg in Sweden, and colleagues conducted a prospective, matched cohort study to examine the excess stroke risk in relation to glycemic control in patients with type 1 diabetes. Patients with type 1 diabetes registered in the Swedish National Diabetes Register (33,453 participants) were each matched to 5 control subjects from the general population (159,924 participants).

The researchers found that 2.3% of patients with diabetes and 0.7% of control subjects were diagnosed with stroke. Type 1 diabetes patients had overall multiple-adjusted hazard ratios (HR) of 3.29 and 2.49 for ischemic and hemorrhagic stroke, respectively, compared with control subjects. With increasing HbA1c, the risk of ischemic and hemorrhagic stroke increased incrementally; the risk of ischemic stroke was significantly increased with HbA1c within target (≤6.9%, multiple-adjusted HR: 1.89). The risks of ischemic and hemorrhagic stroke were markedly increased for HbA1c ≥9.7%, with multiple-adjusted HRs of 7.94 and 8.17, respectively.

"Individuals with type 1 diabetes have an increased risk of ischemic and hemorrhagic stroke, increasing markedly with poor glycemic control," the authors wrote.

Disclosures: The Novo Nordisk Foundation provided some funding for the study.

Reference

Stahl CH, Lind M, Svensson A-M, Gudbjornsdottir S, Martensson A, Rosengren A. Glycemic control and excess risk of ischemic and hemorrhagic stroke in patients with type 1 diabetes: a cohort study of 33,453 patients [Published online December 7, 2016]. J Intern Med. doi:10.1111/joim.12572.

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