Read SH, et al. - This study aimed to report the trends in first ischaemic stroke incidence and case fatality in adults with and without a diagnosis of Type 2 diabetes prior to their ischaemic stroke event in Scotland between 2004 and 2013. In people with vs. without a diagnosis of Type 2 diabetes, no faster decline was noted in the incidence of ischaemic stroke. In addition, increasing prevalence of Type 2 diabetes among stroke patients may mean that declines in case fatality over time will be less marked in the future.

Methods

• This retrospective cohort study was performed, using population-wide hospital admission, death and diabetes datasets.
• Year-specific incidence and case-fatality rates were calculated for people with Type 2 diabetes and for people without diabetes, using negative binomial and logistic regression models.

Results

• A total of 69 757 ischaemic stroke events were reported during 41.0 million person-years of follow-up.
• Between 2004 and 2013, an increase was noted in the prevalence of type 2 diabetes (from 13.5% to 20.3%) among patients who experienced ischaemic stroke.
• Furthermore, for people with and without diabetes, it was reported that stroke incidence rates declined by 2.7% (95% CI 2.4, 3.0) annually [diabetes/year interaction: rate ratio 0.99 (95% CI 0.98, 1.01)].
• Findings demonstrated that type 2 diabetes was associated with an increased risk of ischaemic stroke in men [rate ratio 1.23 (95% CI 1.17, 1.30)] and women [rate ratio 1.41 (95% CI 1.35, 1.48)].
• Researchers found that case-fatality rates were 14.2% and 12.7% in people with Type 2 diabetes and without diabetes, respectively.
• In addition, they observed that case fatality declined by 3.5% (95% CI 2.7, 4.5) annually [diabetes/year interaction: odds ratio 1.01 (95% CI 0.98, 1.02)].