Association of prediabetes and diabetes with stroke symptoms: The reasons for geographic and racial differences in stroke (REGARDS) study

April P. Carson, James F Meschia, Paul Muntner, Linda S. Williams, Brett M. Kissela, Ronald J. Prineas, Dawn O. Kleindorfer, George Howard, Virginia J. Howard, Monika M. Safford

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVE - Stroke symptoms among individuals reporting no physician diagnosis of stroke are associated with an increased risk of future stroke. Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms. RESEARCH DESIGN AND METHODS - This study included 25,696 individuals aged ≥45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who reported no history of stroke or transient ischemic attack at baseline (2003-2007). Glucose measurements, medication use, and self-reported physician diagnosis were used to categorize participants into diabetes, prediabetes, or normal glycemia groups. The presence of six stroke symptoms was assessed using a validated questionnaire. RESULTS - The prevalence of any stroke symptom was higher among participants with diabetes (22.7%) compared with those with prediabetes (15.6%) or normal glycemia (14.9%). In multivariable models, diabetes was associated with any stroke symptom (prevalence odds ratio [POR] 1.28 [95% CI 1.18-1.39]) and two or more stroke symptoms (1.26 [1.12-1.43]) compared with normal glycemia. In analyses of individual stroke symptoms, diabetes was associated with numbness (1.15 [1.03-1.29]), vision loss (1.52 [1.31-1.76]), half-vision loss (1.54 [1.30-1.84]), and lost ability to understand people (1.34 [1.12-1.61]) after multivariable adjustment. No association was present between prediabetes and stroke symptoms. CONCLUSIONS - In this population-based study, almost one in four individuals with diabetes reported stroke symptoms, which suggests that screening for stroke symptoms in diabetes may be warranted.

Original languageEnglish (US)
Pages (from-to)1845-1852
Number of pages8
JournalDiabetes Care
Volume35
Issue number9
DOIs
StatePublished - Sep 2012

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Prediabetic State
Stroke
Physicians
Social Adjustment
Aptitude
Hypesthesia
Transient Ischemic Attack

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Association of prediabetes and diabetes with stroke symptoms : The reasons for geographic and racial differences in stroke (REGARDS) study. / Carson, April P.; Meschia, James F; Muntner, Paul; Williams, Linda S.; Kissela, Brett M.; Prineas, Ronald J.; Kleindorfer, Dawn O.; Howard, George; Howard, Virginia J.; Safford, Monika M.

In: Diabetes Care, Vol. 35, No. 9, 09.2012, p. 1845-1852.

Research output: Contribution to journalArticle

Carson, AP, Meschia, JF, Muntner, P, Williams, LS, Kissela, BM, Prineas, RJ, Kleindorfer, DO, Howard, G, Howard, VJ & Safford, MM 2012, 'Association of prediabetes and diabetes with stroke symptoms: The reasons for geographic and racial differences in stroke (REGARDS) study', Diabetes Care, vol. 35, no. 9, pp. 1845-1852. https://doi.org/10.2337/dc11-2140
Carson, April P. ; Meschia, James F ; Muntner, Paul ; Williams, Linda S. ; Kissela, Brett M. ; Prineas, Ronald J. ; Kleindorfer, Dawn O. ; Howard, George ; Howard, Virginia J. ; Safford, Monika M. / Association of prediabetes and diabetes with stroke symptoms : The reasons for geographic and racial differences in stroke (REGARDS) study. In: Diabetes Care. 2012 ; Vol. 35, No. 9. pp. 1845-1852.
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abstract = "OBJECTIVE - Stroke symptoms among individuals reporting no physician diagnosis of stroke are associated with an increased risk of future stroke. Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms. RESEARCH DESIGN AND METHODS - This study included 25,696 individuals aged ≥45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who reported no history of stroke or transient ischemic attack at baseline (2003-2007). Glucose measurements, medication use, and self-reported physician diagnosis were used to categorize participants into diabetes, prediabetes, or normal glycemia groups. The presence of six stroke symptoms was assessed using a validated questionnaire. RESULTS - The prevalence of any stroke symptom was higher among participants with diabetes (22.7{\%}) compared with those with prediabetes (15.6{\%}) or normal glycemia (14.9{\%}). In multivariable models, diabetes was associated with any stroke symptom (prevalence odds ratio [POR] 1.28 [95{\%} CI 1.18-1.39]) and two or more stroke symptoms (1.26 [1.12-1.43]) compared with normal glycemia. In analyses of individual stroke symptoms, diabetes was associated with numbness (1.15 [1.03-1.29]), vision loss (1.52 [1.31-1.76]), half-vision loss (1.54 [1.30-1.84]), and lost ability to understand people (1.34 [1.12-1.61]) after multivariable adjustment. No association was present between prediabetes and stroke symptoms. CONCLUSIONS - In this population-based study, almost one in four individuals with diabetes reported stroke symptoms, which suggests that screening for stroke symptoms in diabetes may be warranted.",
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AU - Carson, April P.

AU - Meschia, James F

AU - Muntner, Paul

AU - Williams, Linda S.

AU - Kissela, Brett M.

AU - Prineas, Ronald J.

AU - Kleindorfer, Dawn O.

AU - Howard, George

AU - Howard, Virginia J.

AU - Safford, Monika M.

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N2 - OBJECTIVE - Stroke symptoms among individuals reporting no physician diagnosis of stroke are associated with an increased risk of future stroke. Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms. RESEARCH DESIGN AND METHODS - This study included 25,696 individuals aged ≥45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who reported no history of stroke or transient ischemic attack at baseline (2003-2007). Glucose measurements, medication use, and self-reported physician diagnosis were used to categorize participants into diabetes, prediabetes, or normal glycemia groups. The presence of six stroke symptoms was assessed using a validated questionnaire. RESULTS - The prevalence of any stroke symptom was higher among participants with diabetes (22.7%) compared with those with prediabetes (15.6%) or normal glycemia (14.9%). In multivariable models, diabetes was associated with any stroke symptom (prevalence odds ratio [POR] 1.28 [95% CI 1.18-1.39]) and two or more stroke symptoms (1.26 [1.12-1.43]) compared with normal glycemia. In analyses of individual stroke symptoms, diabetes was associated with numbness (1.15 [1.03-1.29]), vision loss (1.52 [1.31-1.76]), half-vision loss (1.54 [1.30-1.84]), and lost ability to understand people (1.34 [1.12-1.61]) after multivariable adjustment. No association was present between prediabetes and stroke symptoms. CONCLUSIONS - In this population-based study, almost one in four individuals with diabetes reported stroke symptoms, which suggests that screening for stroke symptoms in diabetes may be warranted.

AB - OBJECTIVE - Stroke symptoms among individuals reporting no physician diagnosis of stroke are associated with an increased risk of future stroke. Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms. RESEARCH DESIGN AND METHODS - This study included 25,696 individuals aged ≥45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who reported no history of stroke or transient ischemic attack at baseline (2003-2007). Glucose measurements, medication use, and self-reported physician diagnosis were used to categorize participants into diabetes, prediabetes, or normal glycemia groups. The presence of six stroke symptoms was assessed using a validated questionnaire. RESULTS - The prevalence of any stroke symptom was higher among participants with diabetes (22.7%) compared with those with prediabetes (15.6%) or normal glycemia (14.9%). In multivariable models, diabetes was associated with any stroke symptom (prevalence odds ratio [POR] 1.28 [95% CI 1.18-1.39]) and two or more stroke symptoms (1.26 [1.12-1.43]) compared with normal glycemia. In analyses of individual stroke symptoms, diabetes was associated with numbness (1.15 [1.03-1.29]), vision loss (1.52 [1.31-1.76]), half-vision loss (1.54 [1.30-1.84]), and lost ability to understand people (1.34 [1.12-1.61]) after multivariable adjustment. No association was present between prediabetes and stroke symptoms. CONCLUSIONS - In this population-based study, almost one in four individuals with diabetes reported stroke symptoms, which suggests that screening for stroke symptoms in diabetes may be warranted.

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