Incident ischaemic stroke and Type 2 diabetes: trends in incidence and case fatality in Scotland 2004–2013 |
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| Authors: | S H Read D A McAllister H M Colhoun B Farran C Fischbacher J J Kerssens G P Leese R S Lindsay R J McCrimmon S McGurnaghan S Philip N Sattar S H Wild the Scottish Diabetes Research Network Epidemiology Group |
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| Institution: | 1. Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK;2. Institutes of Health and Wellbeing, University of Glasgow, Glasgow, UK;3. Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK;4. Information Services Division, NHS National Services, Edinburgh, UK;5. Department of Diabetes and Endocrinology, University of Dundee, Dundee, UK;6. Institutes of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK;7. Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK;8. Department of Diabetes and Endocrinology, NHS Grampian, Aberdeen, UK;9. BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK |
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| Abstract: | Aim To describe trends in first ischaemic stroke incidence and case fatality in adults with and without a diagnosis of Type 2 diabetes prior to their ischaemic stroke event in Scotland between 2004 and 2013. Methods Using population‐wide hospital admission, death and diabetes datasets, we conducted a retrospective cohort study. Negative binomial and logistic regression models were used to calculate year‐specific incidence and case‐fatality rates for people with Type 2 diabetes and for people without diabetes. Results During 41.0 million person‐years of follow‐up there were 69 757 ischaemic stroke events. Type 2 diabetes prevalence among patients who experienced ischaemic stroke increased from 13.5% to 20.3% between 2004 and 2013. Stroke incidence rates declined by 2.7% (95% CI 2.4, 3.0) annually for people with and without diabetes diabetes/year interaction: rate ratio 0.99 (95% CI 0.98, 1.01)]. Type 2 diabetes was associated with an increased risk of ischaemic stroke in men rate ratio 1.23 (95% CI 1.17, 1.30)] and women rate ratio 1.41 (95% CI 1.35, 1.48)]. Case‐fatality rates were 14.2% and 12.7% in people with Type 2 diabetes and without diabetes, respectively. Case fatality declined by 3.5% (95% CI 2.7, 4.5) annually diabetes/year interaction: odds ratio 1.01 (95% CI 0.98, 1.02)]. Conclusions Ischaemic stroke incidence declined no faster in people with a diagnosis of Type 2 diabetes than in people without diabetes. Increasing prevalence of Type 2 diabetes among stroke patients may mean that declines in case fatality over time will be less marked in the future. |
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