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Prospective Study of Type 1 and Type 2 Diabetes and Risk of Stroke Subtypes

The Nurses’ Health Study

  1. Mohsen Janghorbani, PHD12,
  2. Frank B. Hu, MD23,
  3. Walter C. Willett, MD234,
  4. Tricia Y. Li, MD2,
  5. Joann E. Manson, MD345,
  6. Giancarlo Logroscino, MD3 and
  7. Kathryn M. Rexrode, MD45
  1. 1Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
  3. 3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
  4. 4Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
  5. 5Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts
  1. 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

Abstract

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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 27 March 2007. DOI: 10.2337/dc06-2363.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted March 20, 2007.
    • Received November 18, 2006.
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This Article

  1. Published online before print March 27, 2007, doi: 10.2337/dc06-2363 Diabetes Care July 2007 vol. 30 no. 7 1730-1735
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