Lifestyle Risk Factors Associated with Stroke in Patients with Type 2 Diabetes Mellitus: A Case-control Study

Distinct lifestyle-related cardiovascular risk factors can be present simultaneously in patients with type 2 diabetes mellitus, thus increasing the odds of developing a stroke.

The aim of this study was to establish the risk factors associated with the development of stroke in patients with type 2 diabetes mellitus at the Internal Medicine Services of a referral hospital in Peru.

A case-control study with an unpaired design was conducted, evaluating 324 patients diagnosed with type 2 diabetes mellitus, 108 having a confirmed diagnosis through computed tomography scan and 216 patients without such confirmation, at a reference hospital in Peru from 2012 and 2021. Clinical and laboratory parameters related to lifestyle were evaluated. Odds ratios with 95% confidence intervals were obtained. Logistic regression was used for multivariate analysis.

In the multivariate analysis, being 60 years of age or older: ORa 1.04; 95%CI 1.02-1.07, hypertension: ORa 5.26; 95%CI 2.84-9.74, as well as elevated levels of glycated hemoglobin (HbA1c) levels: ORa 1.11; 95% CI 1.00-1.23 and C- reactive protein (CRP) levels ORa 1.04; 95% CI 1.01-1.06) were significantly associated with stroke risk.

The risk factors associated with the development of strokes in patients diagnosed with type 2 diabetes mellitus were advanced age (over 60 years), chronic inflammation (elevated CRP levels), inadequate metabolic control (elevated HbA1c levels), and, more conclusively, hypertension. These factors are all related to lifestyle, highlighting the importance of promoting proper management in this population.