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Diabetes Might Increase Strokes; Spread of Disease Likely Means More Afflicted at Younger Age, Study Finds

Posted on: Friday, 17 February 2006, 15:00 CST

By JOHN FAUBER

The epidemic of type 2 diabetes cases across the nation is likely to lead to a substantially higher incidence of strokes among middle- age adults and newly diagnosed diabetics, two studies presented Thursday suggest.

The research is the latest warning of an impending health crisis that may result from the spread of diabetes and obesity, especially among younger adults.

It suggests that diabetes is more of a culprit in strokes than cholesterol and some other risk factors, said Arvind Ahuja, a neurosurgeon and co-medical director of the stroke program at St. Luke's Medical Center in Milwaukee.

"The best treatment for stroke is never to have one," Ahuja said. "The way you prevent that is to take care of your diabetes and hypertension."

In one study, researchers analyzed 2,432 strokes that took place among people in the Cincinnati area.

One-third of those patients had been diagnosed with type 2 diabetes before their strokes occurred.

The average age for the stroke was 70.

However, among those younger than 55, being diabetic increased the risk of stroke six to 17 times more than among non-diabetics.

For instance, among black diabetics aged 45 to 54 the annual rate of strokes was 48.5 per 10,000. For whites, it was 32.8 per 10,000.

Among black diabetics aged 55 to 64, the annual stroke rate was 147 per 10,000. For whites it was 73 per 10,000.

Although diabetes substantially increased stroke risk in 35- to 44-year-olds, strokes still were uncommon in that group. In blacks, the rate was 39 per 10,000 and in whites it was 11 per 10,000.

Moves up on risk list

"We are just catching the front end (of the surge in diabetes)," said study author Brett Kissela. "If we have teenage children (newly diagnosed) when they get into their 20s and 30s, the number of strokes are going to go up."

For years, diabetes had been considered the fourth or fifth biggest risk factor for stroke, said Kissela, an associate professor of neurology at the University of Cincinnati. Now, it has moved up to second, just behind high blood pressure, he said.

The research was presented Thursday in Florida at a conference held by the American Stroke Association.

Type 2 diabetes, a disease that largely is preventable through proper diet and exercise, afflicts an estimated 18 million Americans. Another 41 million have a condition known as pre- diabetes, which puts them at high risk for developing diabetes.

About one-third of those with type 2 diabetes don't know they have it.

In type 2 diabetes, the pancreas does not make enough insulin, or the body becomes resistant to it. That leads to excess levels of glucose in the blood, which can damage the eyes, kidneys and nerves as well as blood vessels of the heart and brain.

The surge of type 2 diabetes has closely followed the increasing number of overweight and obese Americans.

More and more, the disease is being found in younger people. Recent data indicate that 200,000 new cases of diabetes are diagnosed each year in those aged 20 to 39. As many as 600,000 new cases are diagnosed in those aged 40 to 59.

Type 2 diabetics increase

In a second study, Canadian researchers found that strokes were occurring in diabetics within five years of their diagnoses.

The researchers looked at 12,272 people who had received new prescriptions for diabetes medications in the early and mid-1990s.

Within five years, more than 9% of them had had a stroke and about 20% of the stroke patients had died.

"One would think that consequences of diabetes would occur over a long period, but we found that new-onset diabetics have double the rate of stroke in the first five years of their diagnosis as the general population," lead author Thomas Jeerakathil, an assistant professor of medicine and neurology at the University of Alberta, said in a statement.

In the last 10 years, the number of type 2 diabetics in the U.S. has increased 50% to 60%, said Jeffrey Binder, a professor of neurology at the Medical College of Wisconsin.

"If these trends continue, we will see an increase in the incidence of stroke in younger people," he said

Binder said the new research is a warning to people with diabetes that they should not waste time getting their condition under control, including lowering their blood pressure and losing weight.

"They might (wrongly) have the impression they have plenty of time to work on the problem," Binder said.

There are a variety of theories about why diabetes increases the risk of stroke.

Diabetes can lead to more build-up of plaque and inflammation in the arteries of the brain.

It also increases a person's heart disease risk, and clots that form in coronary arteries can break loose and become lodged in the arteries of the brain. Diabetes also affects kidney function in a way that increases blood pressure.

Copyright 2006, Journal Sentinel Inc. All rights reserved. (Note: This notice does not apply to those news items already copyrighted and received through wire services or other media.)

Source: Milwaukee Journal Sentinel

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