Incidence and type of stroke in patients with diabetes. Comparison between diabetics and nondiabetics.
BACKGROUND
Stroke is the third cause of death, after heart disease and cancer. Diabetes mellitus is one of the risk factors for stroke and its incidence is increasing, leading to an accentuation of the risk of stroke. We explored the relationship between diabetes and types of stroke, risk factors for the latter one, both in subjects with diabetes and in those without diabetes.


METHODS
The study was conducted on two groups that included 228 subjects; group 1-136 diabetic patients and stroke recently installed; group 2-92 patients without diabetes but stroke recently installed, hospitalized in the Neurologic Department of the County Emergency Hospital, Vâlcea during 2006-2008. On every batch we have made biochemical measurements: glycemic profile, lipid profile, we have established normal values for every group (nondiabetics and diabetic subjects), we determined the type and location of stroke as the result of CT. Statistical analysis was performed using SPSS 15 for Windows application, adapted to processing medical statistics. They calculated the average of the parameters, standard deviation, standard deviation of the average, frequency ranges, tables frequency tests of statistical significance by Student method (t test), and calculation ofHi2 score. We calculated Pearson correlation coefficients that we have interpreted using the rules of Colton.


RESULTS
In both groups ischaemic stroke predominated - 116 (85%) cases in diabetics and 68 (74%) cases in nondiabetics; haemorrhagic stroke was approximately equal in diabetics and nondiabetics 20 (15%) cases vs. 24 (26%) cases. The average age was significantly higher in group 2 versus group 1 (p = 0.026*). Most of the 2nd group subjects are from rural areas, while in 1st group they are from the urban areas. Hypertension was mostly a pre-existing risk factor in both groups. Serum lipid was over the values recommended in both groups. The index of insulinoresistance, materialized by HOMA-IR, was present in 80% of subjects of 1st group and in 52% of subjects of the 2nd group. The incidence rate of stroke was much higher in diabetic population than in the nondiabetics between 2006 and 2008.


CONCLUSIONS
Stroke is installed at a younger age in diabetic subjects than in nondiabetic ones and it is more frequent in nondiabetic males; insulinoresistance is a risk factor present in both groups, but we found a statistical significance only in group 2.
Bălan
Dumitra
D
Emergency County Hospital, Vâlcea, Romania. drmbalan@yahoo.com
Babeş
P A
PA
D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*