Diabetes mellitus is a common disease that affects how the body uses blood sugar and can lead to excess glucose in the blood. This can lead to serious health problems, including cardiovascular disease, nerve, kidney, and eye damage from
diabetes, skin and mouth conditions, foot damage, and hearing impairment. Stroke is a type of cardiovascular disease that occurs when the blood supply to the brain or part of the brain is restricted or blocked entirely. Diabetes is known to increase the risk of incident stroke, but the minutiae of the relationship are unclear. A recent study from Gao and colleagues investigated the duration of diabetes and glycemic control over that time and the risk of stroke in the UK.
In a new paper from Gao and colleagues published in Nature Scientific Reports, the UK Biobank was used to better understand how the risk of stroke is affected by the duration of diabetes and glycemic control. The UK Biobank is a large population-based cohort study of over 500,000 participants between 2006 and 2010, and in this study, participants with diabetes were identified. Age of diagnosis and HbA1c data were used to determine the duration of diabetes diagnosis and glycemic control, respectively. These participants were followed up for a median of 11.6 years, and 982 incident cases of stroke were identified. After adjustment, a higher risk of stroke was associated with longer duration of diabetes (p<0.001). Poor glycemic control was also associated with a higher risk of incident stroke (p<0.001), and HbA1c greater than or equal to 8.0% was associated with 1.78 times higher risk of stroke (95% confidence interval 1.52–2.09). When investigating the subtypes of stroke, poor glycemic control was only associated with ischemic stroke, not haemorrhagic stroke. This study adds weight to the association between diabetes and stroke and suggests that improving glycemic control may have a protective effect against incident stroke.
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GlobalData monitors diabetes and stroke epidemiology in the UK and across many other markets. In the UK, the number of diagnosed prevalent cases of type 2 diabetes is forecast to increase from approximately 4.58 million in 2025 to over five million in 2029. Stroke is also forecast to increase in incidence, with incident cases of stroke in the UK increasing from over 91,000 cases in 2025 to approximately 94,000 cases in 2034.
Understanding the risk factors for stroke is key to decreasing incident cases and improving outcomes for patients. As diabetes cases increase, there is valid concern that adverse cardiovascular events, especially stroke, will increase as well, but Gao and colleagues’ study shows another path forward. Increased access to medication and lifestyle modifications to help patients maintain glycemic control may act as a stroke prevention. The healthcare and societal costs of stroke are high, and by preventing stroke through improved diabetes management, these costs can be delayed or avoided altogether. More research is needed, especially in wider cohorts across more diverse global markets, but this study serves as a proof-of-concept and a roadmap to possible stroke prevention in the diabetic community in the future.
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