Prevalence, Awareness, Treatment, and Control of Diabetes Among 0.98 Million Patients With Stroke/TIA in China: Insights From a Nationwide Cohort Study

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, an...

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Main Authors: Siqi Chen, Gulbahram Yalkun, Hongqiu Gu, Xin Yang, Chunjuan Wang, Xingquan Zhao, Yilong Wang, Liping Liu, Xia Meng, Yong Jiang, Hao Li, Yongjun Wang, Zixiao Li, Jue Liu, Donghua Mi
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Journal of Diabetes
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Online Access:https://doi.org/10.1111/1753-0407.70059
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Summary: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.
ISSN:1753-0393
1753-0407