Prevalence, Awareness, Treatment, and Control of Diabetes Among 0.98 Million Patients With Stroke/TIA in China: Insights From a Nationwide Cohort Study
Siqi Chen
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorGulbahram Yalkun
Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
Search for more papers by this authorHongqiu Gu
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXin Yang
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorChunjuan Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXingquan Zhao
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYilong Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorLiping Liu
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXia Meng
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYong Jiang
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorHao Li
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYongjun Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorCorresponding Author
Zixiao Li
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Correspondence:
Zixiao Li ([email protected])
Jue Liu ([email protected])
Donghua Mi ([email protected])
Search for more papers by this authorCorresponding Author
Jue Liu
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
Correspondence:
Zixiao Li ([email protected])
Jue Liu ([email protected])
Donghua Mi ([email protected])
Search for more papers by this authorCorresponding Author
Donghua Mi
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Correspondence:
Zixiao Li ([email protected])
Jue Liu ([email protected])
Donghua Mi ([email protected])
Search for more papers by this authorSiqi Chen
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorGulbahram Yalkun
Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
Search for more papers by this authorHongqiu Gu
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXin Yang
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorChunjuan Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXingquan Zhao
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYilong Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorLiping Liu
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXia Meng
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYong Jiang
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorHao Li
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYongjun Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorCorresponding Author
Zixiao Li
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Correspondence:
Zixiao Li ([email protected])
Jue Liu ([email protected])
Donghua Mi ([email protected])
Search for more papers by this authorCorresponding Author
Jue Liu
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
Correspondence:
Zixiao Li ([email protected])
Jue Liu ([email protected])
Donghua Mi ([email protected])
Search for more papers by this authorCorresponding Author
Donghua Mi
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Correspondence:
Zixiao Li ([email protected])
Jue Liu ([email protected])
Donghua Mi ([email protected])
Search for more papers by this authorFunding: This study was funded by the National Natural Science Foundation of China (72122001, 81971092, 82171270, 82271343, 92046016).
Siqi Chen and Gulbahram Yalkun contributed equally.
ABSTRACT
Background
A comprehensive epidemiological investigation of the coexistence between diabetes and stroke/TIA in China is urged.
Methods
Data from the Chinese Stroke Center Alliance program, a nationwide multi-center registry study, were used to detect the prevalence, awareness, treatment, and control of diabetes among stroke/TIA. The distribution of diagnosed and undiagnosed diabetes and prediabetes among stroke/TIA patients was investigated, the medical care around diabetes and their respective risk predictors were analyzed, and the association of all above diabetes characteristics with in-hospital death was evaluated using multi-variable Cox regression models.
Results
Of 980 625 patients included, 308 426 (31.5%) had prediabetes, while 365 052 (37.2%) had diabetes, with nearly a third of them undiagnosed (112 969, 30.9%). Of residual aware diabetic patients, 59.0% were treated, with 27.3% controlled. Compared to Han ethnicity, Zhuang ethnicity had a lower prevalence of diabetes (37.3% vs. 35.1%) but were less aware (69.4% vs. 56.5%), treated (59.4% vs. 47.8%), and controlled (27.4% vs. 26.0%). Patients with prediabetes, diagnosed, and undiagnosed diabetes had increasingly higher risks of in-hospital death (adjusted HR [95% CI]: 1.47 [1.35–1.60]; 2.15 [1.97–2.34]; 4.20 [3.87–4.56], all p < 0.001). Unaware and untreated diabetes were independently associated with in-hospital death (adjusted HR [95% CI]: 1.99 [1.85–2.14]; 2.84 [2.63–3.07, both p < 0.001]). Compared with controlled diabetes, those with uncontrolled diabetes had a lower risk of in-hospital death (adjusted HR [95% CI]: 0.77[0.68–0.88], p < 0.001).
Conclusions
The findings indicate that over two-thirds of stroke/TIA patients are exposed to diabetes in China, causing higher in-hospital mortality, which should be screened and intervened early.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
All data used for this analysis are available under reasonable request to the corresponding authors.
Supporting Information
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Table S1. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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