Incidence of stroke, subsequent clinical outcomes and health care resource utilization in people with type 2 diabetes: a real-world database study in France: “INSIST” study
Authors' conclusion
The high burden of stroke among people with T2D, along with the low proportion of patients receiving recommended treatments as per clinical guidelines, necessitates a strengthened and multidisciplinary approach to the CVD prevention and management in people with T2D.
Study context
- Population
- People with T2D without baseline history of stroke, France (SNDS), 2012–2018
- Participants
- 45,331 people
- Exposure
- Hemorrhagic vs ischemic stroke
- Outcome
- Incidence of stroke requiring hospitalization
- Follow-up
- 2012–2018
Methodological detailsreal-world database study, nationally representative subset of French SNDS database
- Real-world database study
- Nationally representative subset of French SNDS database
Main finding
As reported in the abstract
Ischemic stroke
6.80 per 1000 person-years
CI 6.47–7.15
Hemorrhagic stroke
1.38 per 1000 person-years
CI 1.24–1.54
- Incident stroke requiring hospitalization
- 2090 (4.6%)
Observational data: associations, not effects.
Further findings
Per 1000 person-years
| Outcome | Ischemic stroke | Hemorrhagic stroke | aHR (95% CI) | |
|---|---|---|---|---|
| Mortality · median follow-up 2.4 years (IQR 0.6; 4.4) | 144.1 (CI 134.3–154.6) | 291.5 (CI 259.1–327.9) | 1.95 (1.66–2.92) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Per 1000 person-years
| Outcome | Ischemic stroke | Hemorrhagic stroke |
|---|---|---|
| CVD after index stroke · median follow-up 2.4 years (IQR 0.6; 4.4) | 126.4 (CI 117.2–136.4) | 130.9 (CI 107.7–159.0) |
| Stroke recurrence · median follow-up 2.4 years (IQR 0.6; 4.4) | 66.5 (CI 59.2–74.6) | 86.7 (CI 66.4–113.4) |
Cardiovascular disease (CVD) after index stroke · median follow-up 2.4 years (IQR 0.6; 4.4)
- Difference not statistically significant
Stroke recurrence · median follow-up 2.4 years (IQR 0.6; 4.4)
- Difference not statistically significant
Treatment patterns
- GLP-1 RA prescribed, baseline
- 4.2%
- GLP-1 RA prescribed, follow-up
- 6.6%
- Antihypertensives pre-stroke
- 70.9%
- Antihypertensives post-stroke
- 76.7%
- Statins pre-stroke
- 24.1%
- Statins post-stroke
- 30.0%
Health care resource utilization and costs
- Subsequent hospitalization
- 68.8%
- Median total medical costs
- €12,199 (6846; 22,378)
Original publication
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