Risk of Subsequent Diabetes Mellitus in Stroke Survivors According to Poststroke Disability Status and Stroke Type

Abstract

This study used the Korean National Health Insurance System database to examine how poststroke disability and stroke type affect the risk of diabetes mellitus (DM) in stroke survivors. Data for 217 157 stroke survivors and 312 138 matched controls were analyzed. The relative risk of DM was assessed using multivariate Cox proportional hazards regression models. Compared with the controls, stroke survivors had a 2.7-fold higher risk of newly diagnosed DM in the first year and a 15% increased risk thereafter. Severe disability was associated with an elevated DM risk in the first year, but the risk was not significant when a one-year lag period was applied. Ischemic stroke survivors showed significantly higher DM risk than controls, but no significant difference was observed for hemorrhagic stroke survivors. These findings suggest that the type and severity of stroke play crucial roles in the development of DM. Close monitoring and early screening for DM in stroke survivors, particularly those with severe disability or ischemic stroke, could help improve long-term outcomes.