Trends in diabetes prevalence among stroke patients and the effect of diabetes on stroke survival: the Minnesota Heart Survey.
This study documented trends in the prevalence of diabetes among men and women hospitalized for acute stroke and determined the effect of diabetes on short- and long-term survival following stroke. These issues were investigated in the Minnesota Heart Survey, a population-based surveillance system that has monitored trends in stroke morbidity and mortality in the Minneapolis-St Paul metropolitan area since 1970. Clinical data were obtained from the hospital records of 50% samples of residents ages 30 to 74 years who were discharged with a diagnosis of acute stroke in 1970, 1980, and 1985. Between 1970 and 1985, the prevalence of diabetes as listed on the discharge diagnoses among stroke patients 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 time period, both in-hospital and 28-day case fatality rates declined in non-diabetic stroke patients but remained unchanged in stroke patients with diabetes. After controlling for the effects of age, sex, survey 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 non-diabetic individuals. These findings suggest that the prevalence of diabetes has been increasing among stroke patients, and that the diabetic condition is a significant predictor of poorer long-term but not short-term survival following stroke.