Prospective study of type 1 and type 2 diabetes and risk of stroke subtypes: the Nurses' Health Study.
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.


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.
Janghorbani
Mohsen
M
Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. janghorbani@yahoo.com
Hu
Frank B
FB
Willett
Walter C
WC
Li
Tricia Y
TY
Manson
Joann E
JE
Logroscino
Giancarlo
G
Rexrode
Kathryn M
KM
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology