Poor Glucose Control Can Indicate Stroke Risk for Women

By: Alere Staff
Publication Date: Tue, 04/01/2014

A new study revealed that women with type 2 diabetes and poor blood glucose control may be at risk for a stroke.1 The association with poor blood glucose control was only statistically meaningful for women, not men.

Every 1% increase in HbA1c among women was associated with a relative 5% increase in the risk of having a stroke. According to the National Institutes of Health, HbA1c is a test that shows the average level of blood sugar (glucose) over the previous 3 months. This level can show you how well your diabetes is controlled.

There was little difference in stroke risk between black and white women and little difference between women who were and were not taking glucose-controlling medications. There was an increased risk of stroke in women 55 and over.1

This study included 10,876 men and 19,278 women who had newly diagnosed type 2 diabetes and who were free from stroke or coronary heart disease at the start of the study.1 Compared with women with a baseline HbA1c of 6% to 6.9% (for many, the goal is to keep their HbA1c levels within this range), women with values of 8% or higher had significantly increased risks of stroke during follow-up.

Previous studies have shown that diabetes is a risk factor for stroke, but how gender played a role was not clear. According to the new American Heart Association statistics from 2014, women are more affected by stroke, which is the fifth leading cause of death for men but the third leading cause for women.2

Several explanations of why diabetes has a greater effect on women and stroke were offered by the authors, including1:

  • Longer life expectancy of women
  • Levels of cardiovascular risk factors; for example, women with diabetes have significantly higher blood pressure and lipid levels than men with diabetes
  • Treatment bias that favors men; for example, men with diabetes or cardiovascular disease are more likely than women to receive aspirin, statins, or antihypertensive drugs

In a recent statement by the American Stroke Association, control of diabetes, high cholesterol, and smoking cessation programs, in combination with hypertension treatment, has been shown to lead to a decline in stroke mortality.3

The best way to know if you are in control of your diabetes is the same way you know if you are in control of your INR levels when taking warfarin: make sure you participate in testing your blood as often as your doctor instructs.

Talk to your doctor about becoming a patient self-tester and ask to test weekly for your best control of warfarin.4 Home monitoring makes you an important player in your overall treatment, allowing you to take control of your health and aid your physician in prescribing effective care. If you are interested in testing your INR or diabetes at home, contact Alere at 1.800.504.4032 for more information.

  1. Zhao W, et al "Sex differences in the risk of stroke and HbA1c among diabetic patients" Diabetologia 2014; DOI: 10.1007/s00125-014-3190-3.
  2. Alan S. Go, et al. AHA Statistical Update: Heart Disease and Stroke Statistics—2014 Update. Circulation. 2014. published online December 18, 2013. 10.1161/01.cir.0000441139.02102.80.
  3. Lackland DT, et al. Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association. Stroke. December 5, 2013. DOI: 10.1161/01.str.0000437068.30550.
  4. Ansell, J. March 2012. Patient Self-Testing: Real-World Experience within a Comprehensive Support Service Represents a New Standard of Care, Attaining High Quality Anticoagulation Control. Poster presented at: American College of Cardiology.