Association of prediabetes and diabetes with stroke symptoms: the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.
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.


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.
Department of Epidemiology, University of Alabama,Birmingham, AL, USA. apcarson@uab.edu
April P
AP
Carson
Paul
P
Muntner
Brett M
BM
Kissela
Dawn O
DO
Kleindorfer
Virginia J
VJ
Howard
James F
JF
Meschia
Linda S
LS
Williams
Ronald J
RJ
Prineas
George
G
Howard
Monika M
MM
Safford
D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000503:physiopathology*; D008875:Middle Aged; D011236:Prediabetic State / Q000503:physiopathology*; D020521:Stroke / Q000209:etiology / Q000503:physiopathology*