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Diabetes Care 30:1730-1735, 2007
DOI: 10.2337/dc06-2363
© 2007 by the American Diabetes Association
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Epidemiology/Health Services/Psychosocial Research |
Prospective Study of Type 1 and Type 2 Diabetes and Risk of Stroke Subtypes
The Nurses’ Health Study
1 Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
3 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
4 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
5 Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts
Address correspondence and reprint requests to Mohsen Janghorbani, Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: janghorbani{at}yahoo.com
OBJECTIVE— The aim of this study was to examine the relationship between type 1 and type 2 diabetes and risk of stroke subtypes in women.
RESEARCH DESIGN AND METHODS— We followed 116,316 women aged 30–55 years in 1976 through 2002 for incidence of stroke. At baseline and through biennial follow-up, women were asked about their history and treatment of diabetes and other potential risk factors for stroke.
RESULTS— During 2.87 million person-years of follow-up, 3,463 incident strokes occurred. In multivariate analyses, the incidence of total stroke was fourfold higher in women with type 1 diabetes (relative risk [RR] 4.7 [95% CI 3.3–6.6]) and twofold higher among women with type 2 diabetes (1.8 [1.7–2.0]) than for nondiabetic women. The multivariate RR of ischemic stroke was increased sixfold (6.3 [4.0–9.8]) in type 1 diabetes and twofold (2.3 [2.0–2.6]) in type 2 diabetes. Risks for large-artery infarction and lacunar stroke were similar. Type 1 diabetes was also significantly associated with the risk of hemorrhagic stroke (3.8 [1.2–11.8]), but type 2 diabetes was not (1.0 [0.7–1.4]).
CONCLUSIONS— Both type 1 and type 2 diabetes are associated with substantially increased risks of total and most subtypes of stroke.
Abbreviations: CT, computed tomography • MRI, magnetic resonance imaging
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