Risk Factors for Stroke in Type 2 Diabetes Mellitus

Abstract

THE INCIDENCE of cardiovascular disease is increased 2- to 3-fold in patients with type 2 diabetes mellitus, and this increase cannot be explained by the presence of classic risk factors for atherosclerosis, such as smoking, hypertension, and dyslipidemia.¹ In patients with cerebrovascular disease, the presence of type 2 diabetes increases the risk of ischemic cerebral infarction, which accounts for more than three quarters of all strokes, but is not associated with an increased risk of cerebral hemorrhage.^2,3 The crude incidence of stroke among patients with type 2 diabetes can be more than 3 times that in the general population,^4-14 with particularly high rates reported in Sweden¹¹ and the southeastern United States.^8,15 The relative risk of stroke in patients with type 2 diabetes reaches a maximum in the 40- to 60-year-old group, and women comprise a greater proportion of patients with stroke than in the nondiabetic population.¹⁶