Diabetes, Fasting Glucose Levels, and Risk of Ischemic Stroke and Vascular Events

Boden-Albala, Bernadette; Cammack, Sam; Chong, Ji; Wang, Culing; Wright, Clinton; Rundek, Tatjana; Elkind, Mitchell S.V.; Paik, Myunghee C.; Sacco, Ralph L.

doi:10.2337/dc07-0797

Cited by 132Diabetes, Cardiovascular Risks, and LipoproteinsAcute Ischemic Stroke ManagementDiabetes Management and Research

Diabetes, Fasting Glucose Levels, and Risk of Ischemic Stroke and Vascular Events

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Boden-Albala, Bernadette, Cammack, Sam, Chong, Ji, Wang, Culing, Wright, Clinton, Rundek, Tatjana, Elkind, Mitchell S.V., Paik, Myunghee C. +1 more·2008·Diabetes Care

DOI 10.2337/dc07-0797

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Abstract

OBJECTIVE: There is insufficient randomized trial data to support evidence-based recommendations for tight control of fasting blood glucose (FBG) among diabetic subjects in primary stroke prevention. We explored the relationship between FBG among diabetic subjects and risk of ischemic stroke in a multiethnic prospective cohort. RESEARCH DESIGN AND METHODS: Medical and social data and FBG values were collected for 3,298 stroke-free community residents: mean age +/- SD was 69 +/-10 years; 63% were women, 21% were white, 24% were black, and 53% were Hispanic; and follow-up was 6.5 years. Baseline FBG levels were categorized: 1) elevated FBG: history of diabetes and FBG >or=126 mg/dl (7.0 mmol/l); 2) target FBG: history of diabetes and FBG <126 mg/dl (7.0 mmol/l); or 3) no diabetes/reference group. Cox models were used to calculate hazard ratios (HRs) and 95% CI for ischemic stroke and vascular events. RESULTS: In the Northern Manhattan Study, 572 participants reported a history of diabetes and 59% (n = 338) had elevated FBG. Elevated FBG among diabetic subjects was associated with female sex (P < 0.04), Medicaid (P = 0.01), or no insurance (P = 0.03). We detected 190 ischemic strokes and 585 vascular events. Diabetic subjects with elevated FBG (HR 2.7 [95% CI 2.0-3.8]) were at increased risk of stroke, but those with target FBG levels (1.2 [0.7-2.1]) were not, even after adjustment. A similar relationship existed for vascular events: elevated FBG (2.0 [1.6-2.5]) and target FBG (1.3 [0.9-1.8]. CONCLUSIONS: This prospective cohort study provides evidence for the benefits of tighter glucose control for primary stroke prevention.

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Insulin resistance and type 2 diabetes are known cerebrovascular risk factors.
“Insulin resistance and T2D are known cerebrovascular risk factors[18]”
From Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial (2016) · cites this paper as [18]

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Fasting Blood Glucose and the Risk of Stroke and
Infarction, M., & Lawlor, D. A. (2016)

Authors: Boden-Albala, B., Cammack, S., Chong, J., Wang, C., Wright, C., Rundek, T., Elkind, M. S. V., Paik, M. C., & Sacco, R. L.
Affiliations: Columbia University Irving Medical Center (US)
Columbia University (US)
University of Miami (US)
ORCID: Boden-Albala, Bernadette
Wright, Clinton
Rundek, Tatjana
Elkind, Mitchell S.V.
Paik, Myunghee C.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2008-06-01
Volume: 31
Issue: 6
Pages: 1132-1137
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc07-0797
OpenAlex: W2145669276
Cited by: 132
References: 25
Citations by year: 2026: 2 · 2025: 6 · 2024: 4 · 2023: 3 · 2022: 7 · 2021: 11 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 5 · 2016: 8 · 2015: 19 · 2014: 12 · 2013: 8 · 2012: 11
FWCI: 5.06
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Institute of Neurological Disorders and Stroke (NS-29993, R01NS029993)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: diabetes mellitus, fasting blood glucose, ischemic stroke, vascular events, primary stroke prevention, glycemic control, Northern Manhattan Study, racial and ethnic disparities, Medicaid, insurance status, sex differences
MeSH terms: Aged, Black or African American, Blood Glucose, Diabetes Mellitus, Diabetic Angiopathies, Fasting, Female, Hispanic or Latino, Humans, Hyperglycemia, Male, Minority Groups, New York City, Vascular Diseases, Risk Assessment, Stroke, Black People

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Diabetes, Fasting Glucose Levels, and Risk of Ischemic Stroke and Vascular Events

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