(HealthDay News) — Poor glycemic control is associated with increased risks for stroke and death among patients with type 2 diabetes, according to a study published online in Diabetes, Obesity and Metabolism.

Alexander Zabala, MD, from the Karolinska Institutet in Stockholm, and colleagues used the Swedish National Diabetes Register to compare stroke incidence among patients with type 2 diabetes. Each patient with type 2 diabetes (406,271 patients) was matched with 5 individual population-based controls (2,008,640 control individuals; mean age, 64 years for both).

The researchers found that during a median follow-up of 7.3 years, 6.5% of patients with type 2 diabetes and 4.4% of controls were diagnosed with a stroke. The incidence rates were 10.88 versus 7.03 events per 1000 person-years, respectively (hazard ratio [HR], 1.54). In adjusted analysis, the risk for stroke increased with increasing glycated hemoglobin (HbA1c) levels among patients with type 2 diabetes (hazard ratios: 1.27 for 54 to 64 mmol/mol, 1.68 for 65 to 75 mmol/mol, 1.89 for 76 to 86 mmol/mol, and 2.14 for >87 mmol/mol, respectively, compared with HbA1c ≤53 mmol/mol). For every 10 mmol/mol categorical increment of HbA1c, there was a stepwise increased risk for death (hazard ratio, 1.71 for the highest HbA1c category).

“Hyperglycemia is a modifiable risk factor for stroke; therefore, achievement of good glycemic control should be strived for to minimize this complication,” the authors write.

Two authors disclosed financial ties to pharmaceutical companies.


Zabala A, Darsalia V, Holzmann MJ, et al. Risk of first stroke in patients with type 2 diabetes and the relation to glycaemic control: a nationwide observational study. Diab Obes Metab. doi:10.1111/dom.13885

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