Kristensen Frederik Pagh Bredahl, Svane Helene Matilde Lundsgaard, Laugesen Kristina, Al-Mashhadi Sofie Kejlberg, Christensen Diana Hedevang, Sørensen Henrik Toft, Skajaa Nils
Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Eur Stroke J. 2025 Mar;10(1):190-197. doi: 10.1177/23969873241260956. Epub 2024 Jun 14.
The prognosis for stroke patients with type 2 diabetes mellitus (T2DM) remains poorly understood. We examined the risk of mortality and stroke recurrence in stroke patients with T2DM and stroke patients without diabetes.
We conducted a population-based cohort study including all patients diagnosed with a first-time ischemic stroke ( = 131,594) or intracerebral hemorrhage (ICH, = 15,492) in Denmark, 2005-2021. Patients with T2DM were identified using hospital diagnosis codes and glucose-lowering drug prescriptions. We calculated risks, risk differences, and risk ratios, standardized by age, sex, and calendar year of stroke admission.
Following ischemic stroke, the 5-year standardized mortality was 46.1% for patients with T2DM and 35.4% for patients without diabetes (standardized risk difference: 10.7% [95% CI 9.9-11.6]; risk ratio: 1.3 [95% CI 1.3-1.3]). The 5-year risk of recurrence following ischemic stroke was 12.7% for patients with T2DM and 11.3% for those without diabetes (risk difference: 1.4% [95% CI 0.9-2.0]; risk ratio: 1.1 [95% CI 1.1-1.2]). Following ICH, the 5-year mortality was 62.8% for patients with T2DM and 53.0% for patients without diabetes (risk difference: 9.8% [95% CI 7.2-12.4)]; risk ratio: 1.2 [95% CI 1.1-1.2]). The 5-year risk of recurrence after ICH was 9.1% for patients with T2DM and 9.7% for patients without diabetes.
Stroke patients with T2DM were at increased risk of mortality. The risk of stroke recurrence was slightly higher for ischemic stroke patients with T2DM than patients without diabetes, while no difference was observed among ICH patients.
2型糖尿病（T2DM）中风患者的预后仍知之甚少。我们研究了T2DM中风患者和非糖尿病中风患者的死亡风险和中风复发风险。
我们进行了一项基于人群的队列研究，纳入了2005年至2021年在丹麦首次诊断为缺血性中风（n = 131,594）或脑出血（ICH，n = 15,492）的所有患者。使用医院诊断代码和降糖药物处方识别T2DM患者。我们计算了风险、风险差异和风险比，并按中风入院时的年龄、性别和日历年进行标准化。
缺血性中风后，T2DM患者的5年标准化死亡率为46.1%，非糖尿病患者为35.4%（标准化风险差异：10.7% [95% CI 9.9 - 11.6]；风险比：1.3 [95% CI 1.3 - 1.3]）。缺血性中风后，T2DM患者的5年复发风险为12.7%，非糖尿病患者为11.3%（风险差异：1.4% [95% CI 0.9 - 2.0]；风险比：1.1 [95% CI 1.1 - 1.2]）。脑出血后，T2DM患者的5年死亡率为62.8%，非糖尿病患者为53.0%（风险差异：9.8% [95% CI 7.2 - 12.4]；风险比：1.2 [95% CI 1.1 - 1.2]）。脑出血后，T2DM患者的5年复发风险为9.1%，非糖尿病患者为9.7%。
T2DM中风患者的死亡风险增加。T2DM缺血性中风患者的中风复发风险略高于非糖尿病患者，而脑出血患者之间未观察到差异。
