Association of Prediabetes and Diabetes With Stroke Symptoms
The REasons for Geographic And Racial Differences in Stroke (REGARDS) study
- April P. Carson, PHD1⇓,
- Paul Muntner, PHD1,2,
- Brett M. Kissela, MD, MS3,
- Dawn O. Kleindorfer, MD3,
- Virginia J. Howard, PHD1,
- James F. Meschia, MD4,
- Linda S. Williams, MD5,6,
- Ronald J. Prineas, MD, PHD7,
- George Howard, DRPH8 and
- Monika M. Safford, MD2
- 1Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
- 2Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- 3Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, Ohio
- 4Department of Neurology, Mayo Clinic, Jacksonville, Florida
- 5Veterans Administration Medical Center, Health Services Research and Development Center on Implementing Evidence-Based Practice, Indianapolis, Indiana
- 6Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
- 7Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 8Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
- Corresponding author: April P. Carson, .
OBJECTIVE Stroke symptoms among individuals reporting no physician diagnosis of stroke are associated with an increased risk of future stroke. Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms.
RESEARCH DESIGN AND METHODS This study included 25,696 individuals aged ≥45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study who reported no history of stroke or transient ischemic attack at baseline (2003–2007). Glucose measurements, medication use, and self-reported physician diagnosis were used to categorize participants into diabetes, prediabetes, or normal glycemia groups. The presence of six stroke symptoms was assessed using a validated questionnaire.
RESULTS The prevalence of any stroke symptom was higher among participants with diabetes (22.7%) compared with those with prediabetes (15.6%) or normal glycemia (14.9%). In multivariable models, diabetes was associated with any stroke symptom (prevalence odds ratio [POR] 1.28 [95% CI 1.18–1.39]) and two or more stroke symptoms (1.26 [1.12–1.43]) compared with normal glycemia. In analyses of individual stroke symptoms, diabetes was associated with numbness (1.15 [1.03–1.29]), vision loss (1.52 [1.31–1.76]), half-vision loss (1.54 [1.30–1.84]), and lost ability to understand people (1.34 [1.12–1.61]) after multivariable adjustment. No association was present between prediabetes and stroke symptoms.
CONCLUSIONS In this population-based study, almost one in four individuals with diabetes reported stroke symptoms, which suggests that screening for stroke symptoms in diabetes may be warranted.
- Received November 2, 2011.
- Accepted April 1, 2012.
- © 2012 by the American Diabetes Association.
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