For diabetics, the clock is ticking

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A large study has found that the risk of ischemic stroke the most common type rises over time with diabetes, and may triple ten years after the diagnosis is made.

Researchers from Columbia University s Neurological Institute followed nearly 3,300 multiethnic patients over a median of nine years, assessing for diabetes at baseline and annually. None of the aged 59 to 79 subjects began the study with a history of stroke, but over 22 percent had diabetes. Over the course of the study, over 7 percent were diagnosed with an ischemic stroke and another 10 percent developed diabetes. The risk of stroke increased by 70 percent among patients who had been diabetic for five years or less, and by 80 percent for those who had been diabetic between five and 10 years. By the time a patient had at least a 10-year history of diabetes, the risk of ischemic stroke tripled.

Perhaps what is most important about the study findings is that it provides doctors and patients with a clearer sense of the urgency for intervention. A more effective way to encourage diabetics to control this illness, notes one of the researchers, may be for doctors to inform their patients that they have ten years to get the disease under control before their risk for a fatal or disabling stroke triples.

It is indeed an important message, says ACSH's Dr. Ross. Doctors need to emphasize to their diabetic patients that they doctor and patient must make every effort to lower the risk of stroke by keeping blood pressure and cholesterol levels under control. And of course, warning about the major stroke risk may assist in getting smokers to quit. Perhaps this clearer guidepost for intervention will serve as a motivation to these patients.