1270-P: Evolution of Stroke Incidence over 34 Years Follow-up among People with Newly Diagnosed Diabetes and Impaired Glucose Tolerance in the Da Qing Diabetes and Diabetes Prevention Study 1986–2020

Background: Stroke is a leading cause of death among Chinese people; however, the incidence and risk attributable to stroke among adults with diabetes and pre-diabetes have not been quantified. We aimed to discover the evolution in stroke incidence among adults with diabetes and impaired glucose tolerance over a 34-year follow-up period.

Methods: We conducted an observational study among 1632 participants, including 598 individuals with newly diagnosed diabetes (NDD), 540 with impaired glucose tolerance (IGT), and 494 with normal glucose tolerance (NGT), who were initially identified in 1986 and followed up to 34 years. We compared incidence and hazard ratios for stroke across these groups and estimated the difference of median delay time of stroke onset from parametric Weibull distribution models.

Results: Over 34-year follow-up, the cumulative incidence of stroke in NDD group, IGT non-intervention group, IGT intervention group and NGT group was 65.4%, 62.8%, 49.8% and 38.2%, respectively. After adjustment for covariances, the 34 years risk of stroke was significantly higher for those in NDD, hazard ratios (HR) 1.81; 95% CI 1.47-2.72, IGT non-intervention (HR 1.63; 95% CI 1.22-2.18) and IGT intervention groups (HR 1.39; 95% CI 1.11-1.73) compared with those in NGT group. Compared with NDD, a median delay time in onset of stroke was 16.82 years (95% CI 6.50-15.57) in NGT group and 7.84 years (95% CI 4.19-11.48) in IGT intervention. Of note, the subgroup analysis in women revealed that the risk of stroke in IGT intervention group was significantly lower than those in NDD group (HR 0.64, 95% CI 0.47-0.88), and it was comparable to that in NGT controls (HR 0.99,95% CI 0.69-1.40).

Conclusions: More than half of the Chinese adults with newly diagnosed type 2 diabetes and IGT experienced a stroke over 34 years. Lifestyle interventions in women with IGT may favor the risk reduction of stroke.