title: Ischemic Stroke and Its Risk Factors in a Registry-Based Large Cross-Sectional Diabetic Cohort in a Country Facing a Diabetes Epidemic.
abstract: The main aim of this study is to determine the prevalence and risk factors of ischemic stroke among diabetic patients registered in the Saudi National Diabetes Registry (SNDR) database. A cross-sectional sample of 62,681 diabetic patients aged ≥25 years was used to calculate ischemic stroke prevalence and its risk factors. Univariate and multivariate logistic regression analyses were used to assess the roles of different risk factors. The prevalence of ischemic stroke was 4.42% and was higher in the older age group with longer diabetes duration. Poor glycemic control and the presence of chronic diabetes complications were associated with a high risk of ischemic stroke. History of smoking and type 2 diabetes were more frequent among stroke patients. Obesity significantly decreased the risk for ischemic stroke. Regression analysis for ischemic stroke risk factors proved that age ≥45 years, male gender, hypertension, coronary artery disease (CAD), diabetes duration ≥10 years, insulin use, and hyperlipidemia were significant independent risk factors for ischemic stroke. We conclude that ischemic stroke is prevalent among diabetic individuals, particularly among those with type 2 diabetes. Good glycemic, hypertension, and hyperlipidemia control, in addition to smoking cessation, are the cornerstones to achieve a significant reduction in ischemic stroke risk.
authors.affiliation: University Diabetes Center, College of Medicine, King Saud University, P.O. Box 18397, Riyadh 11415, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Rubeaan
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461, Saudi Arabia.
authors.forename: Fawaz
authors.initials: F
authors.lastname: Al-Hussain
authors.affiliation: Registry Department, University Diabetes Center, King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia.
authors.forename: Amira M
authors.initials: AM
authors.lastname: Youssef
authors.affiliation: Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, P.O. Box 3345, Riyadh 11211, Saudi Arabia.
authors.forename: Shazia N
authors.initials: SN
authors.lastname: Subhani
authors.affiliation: Biostatistics Department, University Diabetes Center, King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia.
authors.forename: Ahmad H
authors.initials: AH
authors.lastname: Al-Sharqawi
authors.affiliation: Registry Department, University Diabetes Center, King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia.
authors.forename: Heba M
authors.initials: HM
authors.lastname: Ibrahim
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D058872:Epidemics; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control