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Abstract Details

Characterization of the Associations Between Pre-diabetes and Diabetes with Occurrence of Stroke by its Types, Subtypes and Outcomes among West Africans
General Neurology
S13 - Advances in General Neurology (2:24 PM-2:32 PM)
003
To characterize the associations between stroke occurrence, types, subtypes, severity and outcome indicators according to glycemic status among West Africans

Pre-diabetes and diabetes mellitus (DM) are dysglycemic states associated with stroke occurrence. However, there is limited data from sub-Saharan Africa on the burden and associations between pre-DM/DM and stroke occurrence in West Africa.

The Stroke Investigative Research and 好色先生al Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular, lifestyle, stroke severity and outcomes were performed.

Among 2,935 stroke cases, the mean age was 60.0±14.2 years with 55.2% being males. By glycemic status, 931 (31.7%) were euglycemic, 633 (21.6%) had Pre-diabetes and 1371 (46.7%) had DM. The frequencies of euglycemia, pre-DM and DM among age- and sex-matched stroke-free controls were 69.2%, 13.3% and 17.5% respectively. Pre-diabetes was independently associated with stroke, adjusted odds ratio (95% CI) of 3.68 (2.61 - 5.21) as was having DM, aOR of 4.29 (3.19 - 5.74). The effect size of Pre-DM for ischemic stroke of 3.06 (95% CI: 2.01 - 4.64) was lower than that for DM of 4.82 (3.37-6.89). However, the effect size of Pre-DM for hemorrhagic stroke 6.81 (95% CI: 3.29 - 14.08) is higher than 3.36 (1.94 - 5.86) for DM. Furthermore, the effect sizes of pre-DM for ischemic stroke subtypes were 9.64 (95% CI: 1.30-71.57) for cardio-embolic stroke, 3.64 (95% CI: 1.80-7.34) for small-vessel occlusive disease and 4.63 (95% CI: 0.80-26.65) for large-vessel disease. 

Every 2 out of 3 stroke cases admitted had a blood glucose abnormality. In addition to confirming the known associations between DM and stroke occurrence, we demonstrate that pre-DM is independently and more potently associated with hemorrhagic than ischemic strokes among West Africans.
Authors/Disclosures
Fred Sarfo
PRESENTER 		Fred Sarfo has nothing to disclose.
Mayowa Owolabi, MD, FAAN (Neurology Unit, Dept of Med, UCH) Dr. Owolabi has nothing to disclose.
Kolawole W. Wahab, MD, FAAN (University of Ilorin Teaching Hospital) Dr. Wahab has nothing to disclose.
Albert K. Akpalu, MD (School of Medicine and Dentistry) Dr. Akpalu has nothing to disclose.
No disclosure on file
No disclosure on file
Lukman F. Owolabi, PhD, MSc, FWAPC, FMCP (Bayero University) Dr. Owolabi has nothing to disclose.
Godwin O. Osaigbovo, MD (Jos University Teaching Hospital, Jos) No disclosure on file
No disclosure on file
No disclosure on file
Rufus O. Akinyemi, MD (Institute for Advanced Medical Research and Training) Dr. Akinyemi has nothing to disclose.
Bruce I. Ovbiagele, MD, MSc, FAAN (San Francisco VA) Dr. Ovbiagele has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Stroke Association. Dr. Ovbiagele has received research support from National Institutes of Health. Dr. Ovbiagele has a non-compensated relationship as a President with Society for Equity Neuroscience that is relevant to AAN interests or activities. Dr. Ovbiagele has a non-compensated relationship as a Board Member with World Stroke Organization that is relevant to AAN interests or activities.