Women, type 2 diabetes, and stroke: What’s the association?

Researchers at the Pennington Biomedical Research Center in Baton Rouge, Louisiana, prospectively investigated stroke risk among 10,876 male and 19,278 female patients with type 2 diabetes. The goal of the study, which appeared in the journal Diabetologia, was to better understand the relationship between glycemic control and stroke risk. The researchers note that more women than men tend to die from stroke in developed countries. In 2010 in the United States, 77,109 women and 52,367 men died from stroke, according to the study.

The study identified 2949 incident cases of stroke in these patients during a mean follow-up of 6.7 years. Among the men, although there was a trend toward increased risk of stroke as glycated hemoglobin (HbA1c) levels increased, this increased risk was not statistically significant. Among women, however, those with HbA1c of 8.0–8.9% were 19% more likely to have a stroke than were the women with normal blood sugar; those with 9.0–9.9% HbA1c were 32% more likely to have a stroke, and those above 10% HbA1c were 42% more likely to have a stroke, with each of these associations statistically significant. The adjusted hazard ratios were significantly higher in women older than 55 years.

The researchers claim that the study suggests a graded association between HbA1c and the risk of stroke among women with type 2 diabetes and that poor control of blood sugar has a stronger effect in diabetic women older than 55 years.

In a Diabetologia press release, researcher Dr. Gang Hu states, “Diabetes poses a substantially greater increase in the risk of stroke among women than among men, which merits further investigation. … Females with type 2 diabetes, especially postmenopausal females, are at high risk for stroke. More aggressive blood sugar treatments and better control of other risk factor levels in women with diabetes are likely to substantially reduce stroke in this subgroup.”