title: Current national patterns of comorbid diabetes among acute ischemic stroke patients.
abstract: BACKGROUND
  Type 2 diabetes rates in the general population have risen with the growing obesity epidemic. Knowledge of temporal patterns and factors associated with comorbid diabetes among stroke patients may enable health practitioners and policy makers to develop interventions aimed at reducing diabetes rates, which may consequently lead to declines in stroke incidence and improvements in stroke outcomes.
  
  
  METHODS
  Using the Nationwide Inpatient Sample (NIS), a nationally representative data set of US hospital admissions, we assessed trends in the proportion of acute ischemic stroke (AIS) patients with comorbid diabetes from 1997 to 2006. Independent factors associated with comorbid diabetes were evaluated using multivariable logistic regression.
  
  
  RESULTS
  Over the study period, the absolute number of AIS hospitalizations declined by 17% (from 489,766 in 1997 to 408,378 in 2006); however, the absolute number of AIS hospitalizations with comorbid type 2 diabetes rose by 27% [from 97,577 (20%) in 1997 to 124,244 (30%) in 2006, p < 0.001]. The rise in comorbid diabetes over time was more pronounced in patients who were relatively younger, Black or 'other' race, on Medicaid, or admitted to hospitals located in the South. Factors independently associated with higher odds of diabetes in AIS patients were Black or 'other' versus White race, congestive heart failure, peripheral vascular disease, history of myocardial infarction, renal disease and hypertension.
  
  
  CONCLUSIONS
  Although hospitalizations for AIS in the US decreased from 1997 to 2006, there was a steep rise in the proportion with comorbid diabetes (from 1 in 5 to almost 1 in 3). Specific patient populations may be potential targets for mitigating this trend.
authors.affiliation: Department of Neurology, University of Southern California, Los Angeles, California, USA. towfighi@usc.edu
authors.forename: Amytis
authors.initials: A
authors.lastname: Towfighi
authors.forename: Daniela
authors.initials: D
authors.lastname: Markovic
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D002545:Brain Ischemia / Q000453:epidemiology*; D016000:Cluster Analysis; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011153:Population; D012737:Sex Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American