Prognosis of Ischaemic Stroke is Improving Similarly in Patients with Type 2 Diabetes as in Nondiabetic Patients in Finland

Abstract

Background Case fatality of first ischaemic stroke has improved markedly during the past two decades. Aims To investigate whether stroke patients with type 2 diabetes have shared this favourable development. Methods Nation-wide registers were used to identify all patients with type 2 diabetes in Finland during 1988–2002. All first ischaemic strokes among them and also among all nondiabetic persons were identified from the National Hospital Discharge Register and the Causes of Death Register. Trends over time were calculated, for age-standardised case fatality of first stroke events, separately for two time periods: 0–27 and 28–364 days after the onset of stroke. These trends were compared between patients with type 2 diabetes and nondiabetic patients. Results Altogether, 23097 first-ever ischaemic strokes were recorded among 222 940 persons with type 2 diabetes. The 28 day case fatality was 1·1–1·3 times higher, and the one-year case fatality of 28 day survivors was 1·4–2·2 times higher in patients with type 2 diabetes compared with nondiabetic patients. A significant decline in case fatality trends was observed, but the trends did not differ between type 2 diabetes and nondiabetic patients. Conclusions The study revealed a positive development in survival after the first stroke event in persons with type 2 diabetes, similar to the development in nondiabetic persons. However, the level of case fatality has remained higher in patients with type 2 diabetes.