Stroke in the diabetic and non-diabetic population in Germany: relative and attributable risks, 2005–2007

Icks, Andrea; Scheer, Marsel; Genz, Jutta; Giani, Guido; Glaeske, Gerd; Hoffmann, Falk

doi:10.1016/j.jdiacomp.2010.05.002

« Previous Next »Journal of Diabetes and Its Complications
Volume 25, Issue 2 , Pages 90-96, March 2011

Stroke in the diabetic and non-diabetic population in Germany: relative and attributable risks, 2005–2007☆

Andrea Icks
- Department of Public Health, Center for Health and Society, Heinrich-Heine-University, Düsseldorf, Germany
- Institute of Biometrics and Epidemiology, German Diabetes Center at the Heinrich-Heine-University, Leibniz-Center for Diabetes Research, Düsseldorf, Germany
- Corresponding author. Department of Public Health, Center for Health and Society, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany. Tel.: +49 211 81 1 9780; fax: +49 211 81 1 9778.
Marsel Scheer
- Department of Public Health, Center for Health and Society, Heinrich-Heine-University, Düsseldorf, Germany
Jutta Genz
- Department of Public Health, Center for Health and Society, Heinrich-Heine-University, Düsseldorf, Germany
Guido Giani
- Department of Public Health, Center for Health and Society, Heinrich-Heine-University, Düsseldorf, Germany
Gerd Glaeske
- University of Bremen, Centre for Social Policy Research, Bremen, Germany
Falk Hoffmann
- University of Bremen, Centre for Social Policy Research, Bremen, Germany

Received 8 November 2009; received in revised form 17 May 2010; accepted 28 May 2010. published online 12 July 2010.

Abstract

Background

Reduction of cardiovascular events has been declared to be a main objective in diabetes care. Little is known about incidences of stroke in the diabetic compared to the non-diabetic population and its trend. We evaluated nationwide incidence of stroke in the diabetic compared to the non-diabetic populations as well as relative and attributable stroke risks due to diabetes in Germany.

Methods

Using data of a statutory health insurance (1.6 million members in Germany), we assessed all first strokes in 2005–2007. We estimated sex/age-specific and standardised incidence of strokes in the diabetic and non-diabetic populations and relative and attributable risks due to diabetes.

Results

A total of 6160 subjects had a first stroke [66.6% male, mean age (S.D.)=67.0 (13.9) years]; 31.4% had diabetes. Incidence per 100,000 person years (standard: 2004 German population) in the diabetic and non-diabetic populations, respectively, is as follows: men: 476 [95% confidence interval (CI)=438–514] and 255 (95% CI=243–266); women: 342 (95% CI=305–378) and 173 (95% CI=163–182).

Age-standardised relative risks are as follows: 1.9 (95% CI=1.7–2.0) in men and 2.0 (95% CI=1.8–2.2) in women. The following are attributable risks among exposed: 0.46 (95% CI=0.41–0.51) in men and 0.49 (95% CI=0.43–0.55) in women; population attributable risks are as follows: 0.14 (95% CI=0.11–0.16) in men and 0.14 (95% CI=0.11–0.17) in women.

Conclusions

In this nationwide study, we found the stroke risk in the diabetic population to be still significantly increased compared to the non-diabetic population. The risk increase seems to be as high as earlier observations in other countries, despite large efforts to improve diabetes care.

Keywords: Stroke, Diabetes, Epidemiology, Health service research, Nationwide study