TRENDS IN DIABETES PREVALENCE AMONG STROKE PATIENTS AND THE EFFECT OFDIABETES ON STROKE SURVIVAL - THE MINNESOTA HEART SURVEY

This study documented trends in the prevalence of diabetes among men a nd women hospitalized for acute stroke and determined the effect of di abetes on short- and long-term survival following stroke. These issues were investigated in the Minnesota Heart Survey, a population-based s urveillance system that has monitored trends in stroke morbidity and m ortality in the Minneapolis-St Paul metropolitan area since 1970. Clin ical data were obtained from the hospital records of 50 % samples of r esidents ages 30 to 74 years who were discharged with a diagnosis of a cute stroke in 1970, 1980, and 1985. Between 1970 and 1985, the preval ence of diabetes as listed on the discharge diagnoses among stroke pat ients increased significantly in men (22.4 % vs 10.5 %; p = 0.006) and non-significantly in women (24.7 % vs 15.9 %; p = 0.3). During this t ime period, both in-hospital and 28-day case fatality rates declined i n non-diabetic stroke patients but remained unchanged in stroke patien ts with diabetes. After controlling for the effects of age, sex, surve y year, and level of consciousness, diabetes status had little effect on short-term (28-day) mortality of stroke patients, but the odds of 5 -year mortality among those surviving to 1 year was 2.0 (95 % Cl (1.3, 3.2)) times higher in diabetic compared to nondiabetic individuals. Th ese findings suggest that the prevalence of diabetes has been increasi ng among stroke patients, and that the diabetic condition is a signifi cant predictor of poorer long-term but not short-term survival followi ng stroke.