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DOI: 10.2337/dc06-2363
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Original Research |
PROSPECTIVE STUDY OF TYPE 1 AND TYPE 2 DIABETES AND RISK OF STROKE SUBTYPES: THE NURSES' HEALTH STUDY
1Department of Nutrition, Harvard School of Public Heath; Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
2Department of Nutrition, Harvard School of Public Health, Boston, Mass; USA
3Department of Epidemiology, Harvard School of Public Health, Boston, Mass; USA
4Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass; USA
5Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Mass; USA
janghorbani{at}yahoo.com
ABSTRACT
OBJECTIVE.: To examine the relationship between type 1 and type 2 diabetes mellitus (DM) and risk of stroke subtypes in women.
RESEARCH DESIGN AND METHODS.: We followed 116,316 women 30-55 years old in 1976 through 2002 for incidence of stroke. At baseline and through biennial follow-up, women were asked about history and treatment of DM 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 incidence of total stroke was four-fold higher in women with type 1 (RR 4.7; 95% confidence interval [CI], 3.3-6.6) and two-fold higher among women with type 2 DM (RR 1.8; 95% CI, 1.7-2.0) than for nondiabetic women. The multivariate RR of ischemic stroke was increased six-fold (RR=6.3, 95% CI, 4.0-9.8) in type 1 and two-fold (RR 2.3; 95% CI, 2.0-2.6) in type 2 DM. Risks for large-artery infarction and lacunar stroke were similar. Type 1 DM was also significantly associated with the risk of hemorrhagic stroke (RR 3.8; 95% CI, 1.2-11.8), but type 2 DM was not (RR 1.0; 95% CI, 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.
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