Younger diabetes diagnoses may mean earlier strokes

The risk of having a stroke increases every year a person has diabetes, according to a new study in Stroke, a journal from the American Heart Association. Among those with diabetes for ten years or more, the risk of stroke triples.
These findings raise concern at a time where children are diagnosed with type 2 diabetes at alarming rates.

"If how long a person has diabetes matters, young people with a long history of diabetes are more likely to develop complications earlier in life," said Dr. Mitchell S. V. Elkind of Columbia University Medical Center and the study's senior author. "It's possible that people with diabetes may start having strokes at a younger age."

This means that an adolescent diagnosed with diabetes at age 16 has a tripled risk of suffering a stroke by the time he or she turns 26.

During a stroke, the brain is deprived of oxygen and its symptoms depend on the area of the brain involved. Movement of arms or legs and speech are commonly affected, leaving stroke victims paralyzed or unable to speak clearly. In complicated cases, a stroke can lead to death.

These are high stakes for anyone, but especially a young adult.

Type 1 diabetes is unpreventable. It is genetic and usually presents at childhood or adolescence, independent of weight gain. But, in most cases, type 2 diabetes can be prevented.

Type 2 diabetes was once termed "adult-onset diabetes." But, now, while rates of childhood obesity increase, the cases of childhood diabetes are rising as well.

"We used to think of type 2 diabetes as a disease people get when they are older, after a lifetime of poor dietary habits," said Elkind. "But the age of diagnosis is getting younger and younger because of the obesity problem among young people."

Minority groups are most affected - in particular, American Indians, African-Americans, Asian-Americans and Hispanics. Some states have reported that as many as 75 percent of their new cases are among African-American children.

The correlation between diabetes and stroke risk is not new. It's well known that over time, high levels of sugar in the blood, called glucose, damages blood vessels to the brain and heart.

This new data, however, shows the effects of diabetes over the long-term on stroke risk - especially at the 10-year mark.

Elkind and his team found that the risk of stroke increases by 70 percent in people who have been diagnosed with diabetes for less than five years; 80 percent in people diagnosed with diabetes for five to 10 years; and three-fold, or 300 percent, in people who have had diabetes for 10 years or more.

The reason for this spike is unclear. The findings also do not address whether well-controlled diabetes decreases the risk.

But, these results highlight the need to teach diabetes prevention and weight management not just to adults, but to adolescents as well.