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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31630

    標題: Long-term risk of stroke in type 2 diabetes patients with diabetic ketoacidosis: A population-based, propensity score-matched, longitudinal follow-up study
    作者: Chen, Y. -L.
    Weng, S. -F.
    Yang, C. Y.
    Wang, J. J.
    Tien, K. -J.
    貢獻者: Chi Mei Med Ctr, Dept Internal Med, Div Endocrinol & Metab, Chia Li Branch
    Kaohsiung Med Univ, Dept Healthcare Adm & Med Informat
    Chi Mei Med Ctr, Dept Internal Med, Div Endocrinol & Metab
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management
    關鍵字: Diabetic ketoacidosis
    Type 2 diabetes
    日期: 2017-06
    上傳時間: 2018-11-30 15:50:51 (UTC+8)
    出版者: Masson Editeur
    摘要: Aim. - To investigate the long-term risk of stroke in type 2 diabetes (T2D) patients with previous episodes of diabetic ketoacidosis (DKA). Methods. - This retrospective nationwide population-based cohort study was conducted using Taiwan's National Health Insurance database. Claims data from 2000 to 2002 were extracted for 3572 T2D patients with DKA and 7144 controls matched for age, gender, diabetes complications severity index, frequency of clinical visits and baseline comorbidities. Patients with type 1 diabetes (T1D), identified by glucagon C-peptide stimulation or glutamic acid decarboxylase (GAD) antibody blood tests and possession of a catastrophic illness certificate were excluded. All patients were tracked until a new stroke diagnosis, death or the end of 2011. Results. - Of the 3572 selected patients, 270 with DMA and 404 of the 7144 controls were diagnosed with a new stroke, giving an incidence rate ratio (IRR) of 1.56 (95% CI: 1.34-1.82; P < 0.0001). DKA patients had a higher risk of ischaemic stroke than those without DKA (IRR: 1.62, 95% CI: 134-1.96; P < 0.0001), and DICA patients with hypertension and hyperlipidaemia were at even greater risk of stroke. Also, DMA patients were at particular risk for stroke during the first half-year following DKA diagnosis. After adjusting for patient characteristics and comorbidities, these patients were 1.55 times more likely to have a stroke than those without DMA (95% CI: 1.332-1.813, P < 0.0001). Conclusion. - T2D patients with previous DMA have a higher risk of stroke, especially ischaemic strokes. (C) 2016 Elsevier Masson SAS. All rights reserved.
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