PROSPECTIVE STUDY OF TYPE 1 AND TYPE 2 DIABETES AND RISK OF STROKE SUBTYPES: THE NURSES' HEALTH STUDY

  1. MOHSEN JANGHORBANI, PhD (janghorbani{at}yahoo.com)1,2,
  2. FRANK B. HU, MD2,3,
  3. WALTER C. WILLETT, MD2,3,4,
  4. TRICIA Y. LI, MD2,
  5. JOANN E. MANSON, MD3,4,5,
  6. GIANCARLO LOGROSCINO, MD3 and
  7. KATHRYN M. REXRODE, MD4,5
  1. 1Department of Nutrition, Harvard School of Public Heath; Department 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, Mass; USA
  3. 3Department of Epidemiology, Harvard School of Public Health, Boston, Mass; USA
  4. 4Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass; USA
  5. 5Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Mass; USA

    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.

    Footnotes

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

    This Article

    1. Published online before print March 27, 2007, doi: 10.2337/dc06-2363
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