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(Stroke. 1996;27:1316-1318.)
© 1996 American Heart Association, Inc.

Articles

Autonomic Neuropathy Predicts the Development of Stroke in Patients With Non-Insulin-Dependent Diabetes Mellitus

Jari P. Toyry, MD; Leo K. Niskanen, MD; Esko A. Lansimies, MD; Kaarina P.L. Partanen, MD Matti I.J. Uusitupa, MD

the Departments of Clinical Physiology (J.P.T., E.A.L.), Clinical Nutrition (M.I.J.U.), Medicine (L.K.N.), and Clinical Radiology (K.P.L.P.), Kuopio University Hospital and University of Kuopio (Finland).

Correspondence to Jari Toyry, MD, Department of Clinical Physiology, Kuopio University Hospital, FIN 70210 Kuopio, Finland. E-mail jtoyry@messi.uku.fi.

Background and Purpose Our aim was to determine the predictive factors for stroke in patients with non–insulin-dependent diabetes mellitus (NIDDM).

Methods We studied 133 patients with NIDDM at the time of diagnosis and 5 and 10 years later.

Results The number of new fatal or nonfatal strokes was 19 (14.7%; 14 after 5-year examination). High initial fasting blood glucose (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.04 to 1.4) and the use of ß-blocking agents (OR, 6.7; 95% CI, 2.1 to 21.5) at baseline and the presence of parasympathetic neuropathy (OR, 6.7; 95% CI, 1.5 to 29.9), or sympathetic autonomic nervous dysfunction (OR, 1.1; 95% CI, 1.01 to 1.2), hypertriglyceridemia (OR, 5.7; 95% CI, 1.1 to 31.0), or use of ß-blocking agents (OR, 6.4; 95% CI, 1.3 to 31.2), and high fasting plasma glucose (OR, 1.2; 95% CI, 1.0 to 1.5) determined at 5-year examination predicted the development of stroke.

Conclusions Autonomic neuropathy is an independent risk factor for stroke in NIDDM.

Key Words: autonomic dysfunctions • diabetes mellitus • neuropathies, hereditary sensory and autonomic • risk factors • stroke

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