Periodontal Disease as a Predictor of Undiagnosed Diabetes or Prediabetes in Dental Patients

Abstract Objectives The study investigates whether periodontal parameters can identify subjects with undiagnosed diabetes mellitus (DM) or pre-DM in patients seeking dental treatment at a university dental hospital. Materials and Methods Adults older than 35 years, not being diagnosed with DM before and have at least one of the risk factors of DM were included in the study. All subjects received a complete periodontal examination, filled a medical history survey, and a fasting blood glucose measurement was obtained. A multiple logistic regression test using a backward elimination method to assess factors that predict if the participant is healthy, prediabetic or diabetic was done. A p-value of <0.05 was considered significant. Results A total of 61 subjects were enrolled with an average age of 42.9 ± 9.4 years. Having a family member diagnosed with DM was reported by 64.5% of the subjects; 59% were diagnosed with advanced periodontal disease. The final logistic regression model included smoking, hypertension, family history of DM, and percentage of clinical attachment loss >3 mm was statistically significant (P < 0.001). The model explained 47.7% of the diabetes condition and correctly classified 69.4% of cases. Participants with a family history of diabetes are 4.98 times more likely to exhibit prediabetic or diabetic status. Each unit increase in the percentage of clinical attachment loss increases the likelihood of participant to be prediabetic or diabetic by 1.104 times. Conclusion Dental patients presenting with severe clinical attachment loss and family history of DM have increased likelihood of undiagnosed DM or pre-DM and would benefit from screening at the dental office.

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Status of Tobacco Smoking and Diabetes with Periodontal Disease

Journal of Nepal Medical Association ◽

10.31729/jnma.3610 ◽

2018 ◽

Vol 56 (213) ◽

pp. 818-824

Author(s):

Sujaya Gupta ◽

Anjana Maharjan ◽

Bhageshwar Dhami ◽

Pratikshya Amgain ◽

Sanjeeta Katwal ◽

...

Keyword(s):

Family History ◽

Periodontal Disease ◽

Periodontal Diseases ◽

Essential Element ◽

Smoking Behaviour ◽

Clear Understanding ◽

Family History Of Diabetes ◽

Dental Patients ◽

History Of ◽

Dose Dependent

Introduction: Periodontitis is multifactorial disease that along with dental caries remains one of the commonest cause of tooth loss worldwide. Effective management requires clear understanding of risk factors. Smoking has a dose-dependent effect on periodontium. Similarly, individuals with diabetes have severe forms of periodontal diseases. We aim to assess the prevalence of periodontal disease in dental patients in relation to smoking and diabetes. Methods: The study was conducted among 522 patients visiting the Periodontics Department, Kantipur Dental College. Individuals willing to participate had to sign an informed consent and undergo interview and clinical examination. Data collection, done on a structured proforma, was analysed using SPSS 20.0. Results: Prevalence of periodontitis was 372 (71.3%), diabetes 33 (6.3%) and smoking as 138 (26.4%). Hypertension was observed in 64 (12.3%) patients and family history of diabetes among 94 (18%). Among the 372 periodontitis patients, smoking behaviour was present in 120 (32.3%), diabetes in 32 (8.6%), family history of diabetes in 72 (19.4%) and hypertension in 62 (16.7%). Conversely, 120 (87%) smokers, 33 (97%) diabetics, 72 (76.6%) with family history of diabetes, 62 (96.9%) hypertensive, 216 (41.4%) male and 156 (29.9%) female participants had periodontitis. Smoking behaviour was more in males: 115 (39.4%) compared to 23 (10%) females. Conclusions: Periodontitis was significantly associated with smoking, diabetes, hypertension and age. It is recommended that tobacco cessation and diabetes control be promoted as an integral component of periodontal therapy and oral health be included as an essential element of general health when conducting national health surveys.

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New Onset Diabetes after Transplant – Risk Factors, Clinical Profile and Outcome

Integrative Diabetes and Cardiovascular Diseases ◽

10.18314/idcd.v2i1.1015 ◽

2018 ◽

Vol 2 (1) ◽

pp. 35-40

Author(s):

Sakthirajan R ◽

Dhanapriya J ◽

Dineshkumar T ◽

Balasubramaniyan T ◽

Gopalakrishnan N ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Family History ◽

Fasting Blood Glucose ◽

Hcv Infection ◽

Clinical Profile ◽

Family History Of Diabetes ◽

Onset Diabetes ◽

History Of ◽

New Onset

Background: New onset diabetes after transplant (NODAT) remains one among the significant threats to both renal allograft and patient survival. The aim of this study was to analyse the clinical profile and risk factors for NODAT.Methods: This prospective observational study involved patients who underwent renal transplantation in our centre between 2010 and 2015.Results: During the mean follow up period of 18 ± 6 months, incidence of NODAT was 26.6% and the cumulativeincidence was highest in the first year after transplant. Recipient age, pre transplant impaired fasting glucose, Hepatitis C virus (HCV) infection, family history of diabetes, tacrolimus, post transplant hypertriglyceridemia and metabolic syndrome were found to be statistically significant risk factors for NODAT. In Cox multivariate regression analysis, age and family history of diabetes were found to be independent risk factors for NODAT. Fasting C-peptide level underlines insulin resistance as predominant mechanism for NODAT in two third of patients. There were higher incidence of urinary tract infection in the NODAT patients. NODAT was found to be an independent risk factor for fungal infection and 10 year cardiovascular risk in the renal recipients. There was no significant impact of NODAT on short term graft and patient survival.Conclusion: Age, pre-transplant fasting blood glucose, family history of diabetes, HCV infection and tacrolimus were found to be the important risk factors, with insulin resistance as the predominant mechanism for NODAT.

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Prevalence and Risk Factors for Glucose Intolerance among Saudi Women with Gestational Diabetes

Journal of Diabetes Research ◽

10.1155/2018/4282347 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hayfaa Wahabi

Keyword(s):

Risk Factors ◽

Family History ◽

Gestational Diabetes ◽

Glucose Intolerance ◽

Fasting Blood Glucose ◽

Positive Family History ◽

Family History Of Diabetes ◽

Saudi Women ◽

History Of ◽

One Year

Objectives. The objective of this study was to determine the incidence and risk factors of glucose intolerance one year after delivery in women with gestational diabetes (GDM). Methods. All women who had GDM and completed one year since delivery at King Khalid University Hospital were contacted to participate in the study. Based on to the American Diabetes Association criteria and the results of fasting blood glucose (FPG) and HbA1c, participants were classified into three groups: diabetic, impaired glucose tolerance (IGT), and normal. The incidence of diabetes and IGT was calculated. Clinical, biochemical, and sociodemographic predictors of glucose intolerance were compared between the three groups. Odds ratio (OR) for risk factors with P value less than 0.05 was calculated. Results. From a total 316 eligible women, 133 fulfilled the inclusion criteria and agreed to participate in the study. From the study participants, 58 (44%) women were normoglycemic, 60 (45%) women had IGT, and 15 (11%) women were diabetic. The odds of developing IGT or diabetes increased to nearly fourfold when women needed insulin for the control of GDM during pregnancy (OR 3.8, 95% CI 0.81–18.3, P=0.08) and to nearly one-and-a-half-fold when they have positive family history of T2DM (OR 1.2, 95% CI 0.74–2.09, P=0.40). Nevertheless, none of the odds ratios was statistically significant. Conclusion. The incidence of postpartum hyperglycemia (diabetes and IGT) is very high in Saudi women with GDM. Family history of diabetes and insulin treatment of GDM may be predictors of postpartum hyperglycemia.

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Undiagnosed diabetes mellitus and associated factors among adults in Ethiopia: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-03669-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Getachew Yideg Yitbarek ◽

Gashaw Walle Ayehu ◽

Sintayehu Asnakew ◽

Ermias Sisay Chanie ◽

Wubet Alebachew Bayih ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Family History ◽

Impaired Fasting Glucose ◽

Associated Factors ◽

Fasting Glucose ◽

Undiagnosed Diabetes ◽

Family History Of Diabetes ◽

History Of ◽

Undiagnosed Diabetes Mellitus

AbstractDiabetes has become a major public health problem, with 4.6 million deaths annually. The number of people living with undiagnosed diabetes is on the rise and has a diverse prevalence. Thus, this systematic review and meta-analysis was aimed to synthesize the pooled estimate prevalence of undiagnosed diabetes mellitus, impaired fasting glucose and its associated factors in Ethiopia. The databases Medline, Hinari, Google Scholar, and Google search were used to find potential studies published from January 2013 until January 2021. Extracted data were entered into the excel spreadsheet. The random effects model with Der Simonian-Laird weights was used to assess the pooled estimate of prevalence of undiagnosed diabetes, impaired fasting glucose, and its associated factors. The Cochrane Q-test and I2 statistics were used to screen for statistical heterogeneity. A funnel plot and Egger's statistical test were also used to search for any publication bias (small study effect). After extensive searching of articles on different databases, a total of nine studies were included for this systematic review and meta-analysis. In random effects model, the pooled prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was 5.75%, 95% CI (3.90–7.59%), and 8.94%, 95% CI (2.60–15.28%), respectively. Regarding the associated factors, participants family history of diabetes was significantly associated with diabetes status. The pooled odds of developing diabetes mellitus among participants with a family history of diabetes mellitus were about 3.56 times higher than those without a family history of diabetes mellitus (OR = 3.56, 95% CI (2.23, 5.68)). In this review, the higher prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was observed among adults in Ethiopia. Family history of diabetes was found to have an association with increased risk of diabetes mellitus. Our finding highlights the need of screening at the community level, with special focus on adults with family history of diabetes mellitus.

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Assessing Factors Related to Waist Circumference and Obesity: Application of a Latent Variable Model

Journal of Environmental and Public Health ◽

10.1155/2015/893198 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Sahar Dalvand ◽

Jalil Koohpayehzadeh ◽

Masoud Karimlou ◽

Fereshteh Asgari ◽

Ali Rafei ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Family History ◽

Waist Circumference ◽

Latent Variable ◽

Fasting Blood Glucose ◽

Latent Variable Model ◽

Variable Model ◽

Family History Of Diabetes ◽

History Of

Background. Because the use of BMI (Body Mass Index) alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome) and obesity (binary outcome) among Iranian adults.Methods. Data included 18,990 Iranian individuals aged 20–65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity) with independent variables including age, gender, PR (Place of Residence), PA (physical activity), smoking status, SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), CHOL (cholesterol), FBG (Fasting Blood Glucose), diabetes, and FHD (family history of diabetes).Results. All variables were related to both obesity and waist circumference (WC). Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity.Conclusions. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population.

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Prevalence of T2 Diabetes Mellitus (DM) Among the Rural People of Selected villages Of Bangladesh

Community Based Medical Journal ◽

10.3329/cbmj.v4i1.53559 ◽

2015 ◽

Vol 4 (1) ◽

pp. 22-29

Author(s):

Md Yunus Ali ◽

Maksuda Begum ◽

Sultan Sobnam Dipu

Keyword(s):

Diabetes Mellitus ◽

Family History ◽

Middle Class ◽

Demographic Data ◽

Fasting Blood Glucose ◽

Positive Association ◽

Cross Sectional ◽

Rural People ◽

Family History Of Diabetes ◽

History Of

Objectives: This cross-sectional study was conducted to find out the prevalence of type 2 diabetes and pre-diabetes ((PD) (Impaired fasting glucose-IFG, impaired glucose tolerance-IGT)) and to see the associations with risk factors. Methods: Two villages were randomly selected from rural area of Mymensingh district. 125 study subjects (≥30 years) were selected with systematic procedure but 118 samples were participated in the study. Below 30 years, diagnosed case of diabetes and urban people were excluded from study. Socio-demographic data were collected on a pre-tested interview schedule through face to face interview. DM, PD were interpreted by estimating fasting blood glucose level and 2 hour after 75 gm glucose load. Obesity was assigned by BMI. SPSS program (version 11.5) used for data analysis. Results: Mean age of participants was 46.68 with SD ± 12.698. Female participation (66.9%) was double compare to male, literacy rate was (64.4%) with female illiteracy of 29.67%. House wives (61.9%) were more than other professions. Middle class people were nearly 73%, Poor 14.4%, sedentary life style 11% and depressives 14.4% evident in study. A 20.3% people did laborious works. 17.8% had the family history of diabetes. Smokers (53.4%) were more than the non-smokers. Majority (89.0%) of rural people eat rice thrice a day. Normal BMI 61.0%, underweight 31.4% and 7.6% overweight observed. Overall prevalence of T2 DM was 11.0% showing increase trend of diabetes compared to 8.6% estimated in 2000 and higher than several studies of home and abroad. Female showed higher prevalence (7.6%) compare to male (P>0.05). The overall prevalence of PD was 16.1% evident in this study. The prevalence of IFG and IGT were 8.5% and 7.6% respectively. Female showed higher prevalence of IFG (5.1%) and IGT (5.9%) than male (P>0.05). House wives showed higher prevalence (5.6%) of DM compare to other professions (P>0.05). Illiterates showed more PD (10.3%) and less DM (1.7%) but literates showed more (9.3%) DM (P >0.05). DM (6.7%) and PD (11.8%) more were among the middle class (P=0.018). A high prevalence of PD (13.6%) and DM (9.3%) noticed among non-sedentary lifestyle (P >0.05). Smoker showed higher DM (8.5%) and PD (11.8%). (P-0.071). Prevalence of PD and DM were high among the people with physically less active (P =0.795). Depressives showed more prevalence of DM (8.5%) and PD (13.5%), (P=0.345). increased frequency of rice eating (P=0.004), people with normal BMI (P=0.081) and family history of DM (P=0.000) showed positive association with diabetes mellitus. CBMJ 2015 January: Vol. 04 No. 01 P: 22-29

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Clinical Symptoms Used for Screening Diabetic Populations with Family History of Type 2 Diabetes Mellitus

Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) ◽

10.22146/rpcpe.33881 ◽

2018 ◽

Vol 1 (2) ◽

pp. 24

Author(s):

Siti Marlina ◽

I Dewa Putu Pramantara ◽

Hari J. Kusnanto ◽

Mark Alan Graber

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Family History ◽

Clinical Symptoms ◽

Fasting Blood Glucose ◽

Family History Of Diabetes ◽

Birth History ◽

History Of

Background: The annual prevalence of diabetes is increasing worldwide. With this growing concern, the identification of clinical symptoms in high risk populations, such as those with a family history of diabetes, is becoming increasingly important.Objectives: This study aimed to determine the use of clinical symptoms and history as a screening tool for diabetes mellitus (DM) in a population with a family history of Type 2 Diabetes Mellitus (T2DM).Methods: The design of this research was a cross sectional study. The subjects of this study were a sample population with family history of T2DM living in Kasihan and Sewon District of Bantul Regency. Data were collected through interviews with questionnaires, anthropometric measurements, total cholesterol tests, triglycerides and fasting blood glucose tests. Data analysis used univariate, bivariate and multivariate analyses. For screening purposes, validity was performed against risk factors with fasting blood glucose as a gold standard.Results: Prevalence of DM was 30.5%, and prediabetes 26.5%. Body Mass Index (BMI) prevalence =23 kg/m2 59.02%, hypertension 42.62%, physical inactivity 21.31%, and dyslipidemia 78.69%. Polyuria, polydipsia, and weight loss were significantly associated with T2DM. Birth history of weight =4 kg or Gestational Diabetes Mellitus (GDM) was a risk factor associated with T2DM incidence (p = 0.018; OR: 1.93; CI 95%: 1.12-3.34). The sensitivity of a combination of several factors, birth history of baby =4 kg or GDM with dyslipidemia (sensitivity 87.3% specificity 40.9%), birth history of weight =4 kg or GDM with dyslipidemia and hypertension (sensitivity 94.7% specificity 26.7%), combination of the five factors studied (sensitivity 92.3% specificity 50%). Combination of birth history of heavy baby =4kg or GDM and BMI = 23 kg/m2 and hypertension had a likelihood ratio of 9.Conclusions: This study determined the prevalence of T2DM in populations with a family history of diabetes is high, with birth history of weight = 4 kg or GDM as a factor associated with T2DM, and other clinical symptoms having a fairly high prevalence. Therefore, a comprehensive lifestyle change needs to be done.

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PREDICTION OF TYPE 2 DIABETES MELLITUS BY FINDRISC ON PRE-DIABETES PATIENTS OVER 45 YEARS OLD

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.4.3 ◽

2012 ◽

pp. 20-29

Author(s):

Van Vy Hau Nguyen ◽

Hai Thuy Nguyen

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Family History ◽

Waist Circumference ◽

Undiagnosed Diabetes ◽

Oral Glucose ◽

Family History Of Diabetes ◽

History Of

Objectives: To predict the risk of type 2 diabetes mellitus (T2DM) in ten years by applying FINDRISC. Methods: 131 patients were diagnosed pre-diabetes according to the ADA (2010) criteria using fasting plasma glucose, 2h after 75g oral glucose load and/or HbA1c. FINDRISC includes eight parameters: age, abdominal obesity, waist circumference, family history of diabetes, physical activity, history of increased glucose and using of anti-hypertensive medications and eating habit of vegetables fruits or berries. Results: In the eight element of FINDRISC, BMI and waist circumference, family history of diabetes, history of hypertension and antihypertensive drug use are risk factors are most important. The area under the curve order is 0.912; 0.879; 0.819; 0.720 and 0.664 respectively. Application FINDRISC- South Asian we recorded the optimal cut points 9 points (Se = 0.61, Sp = 0.85, p <0.001) to detect pre-diabetes and 15 points (Se = 1.00 and Sp=0.91, p< 0.0001) to detect diabetes. Risk of diabetes in 10 years by using FINDRISC-Asian scale is higher than using FINDRISC- European scale: 7.68% vs 4.91% in men, 9.64% vs 8.17% in female and 8.74% vs 6.68% for both sexes, respectively. Conclusion: We can use FINDRISC to predict the risk of type 2 diabetes mellitus, and screening type 2 undiagnosed diabetes mellitus in Vietnam if the BMI and waist circumference are change criteria for South Asia.

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Undiagnosed diabetes mellitus and related factors in East Gojjam (NW Ethiopia) in 2016: a community-based study

Journal of Public Health Research ◽

10.4081/jphr.2017.834 ◽

2017 ◽

Vol 6 (1) ◽

Cited By ~ 12

Author(s):

Amsalu Taye Wondemagegn ◽

Habtamu Mellie Bizuayehu ◽

Dagninet Derebe Abie ◽

Getachew Mengistu Ayalneh ◽

Tenaw Yimer Tiruye ◽

...

Keyword(s):

Diabetes Mellitus ◽

Family History ◽

Gestational Diabetes ◽

Sedentary Behaviour ◽

Undiagnosed Diabetes ◽

Community Based ◽

Related Factors ◽

Family History Of Diabetes ◽

History Of ◽

Undiagnosed Diabetes Mellitus

Introduction. Currently, diabetes is the second most common non-communicable disease (NCD) in Ethiopia. Its burden is 4.8% in this country, even though three quarter of its population live with undiagnosed diabetes mellitus (DM), which causes complications like heart failure, blood vessels, eyes, kidneys and nerves damages. Early detection of DM is vital for a timely intervention to prevent these life threatening complications. The aim of this study was to assess the prevalence of undiagnosed DM and related factors in East Gojjam, North West Ethiopia, in 2016. Materials and methods. A community-based cross-sectional study was conducted among 757 individuals in East Gojjam from June to September 2016. The sampled population was selected using multi-stage cluster sampling method. Basic data were collected in Amharic (local language) and a pretested interviewer administered the questionnaire. Peripheral blood samples were collected by puncturing the ring finger in order to measure fasting blood glucose. Univarite and multivariate logistic regressions analysis were performed using Statistical Package for Social Sciences (SPSS) software version 20.0. Results. The percentage of undiagnosed DM in the study area was 11.5% (95%CI=9.2, 13.7). The prevalence was 11.3% among male vs. 11.8% among female; 13.4% in urban areas vs. 10.3% in rural areas. The occurrence of undiagnosed DM was mainly associated with older age (AOR=5.99, 95%CI=1.54, 23.24), family history of diabetes (AOR=9.86, 95%CI=4.25, 22.89), history of gestational diabetes (AOR=3.01, 95%CI=1.17, 8.39) and sedentary behaviour >4 hours per day (AOR=2.13, 95%CI=1.04, 4.34). Being non-smoker (AOR=0.05, 95%CI=0.01, 0.17) and unmarried (AOR=0.09, 95%CI=0.02, 0.42) were also predictive characteristics for undiagnosed DM in the study area. Conclusions. In conclusion, this study revealed a relatively high prevalence of undiagnosed DM in the study area. The occurrence of undiagnosed DM was significantly higher when associated with the age of the participants, their marital status, history of hypertension, diabetes family history, history of gestational diabetes mellitus, current smoking practices and sedentary behaviour. Thus, efforts have to be made, particularly by the individuals involved in health practice, to early detect the disease and thereby initiate a suitable therapeutic service, before complications arise.

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The Prevalence of Dyslipidemia and Hyperglycemia among Stroke Patients: Preliminary Findings

Stroke Research and Treatment ◽

10.1155/2019/8194960 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Iyad Ali ◽

Mahmoud Abuissa ◽

Anan Alawneh ◽

Omar Subeh ◽

Ahmad Abu Sneineh ◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Glycosylated Hemoglobin ◽

Fasting Blood Glucose ◽

Significant Risk ◽

High Density Lipoproteins ◽

Stroke Patients ◽

Family History Of Diabetes ◽

Low Hdl ◽

History Of

Background/Aim. Stroke or cerebrovascular accident is defined as sudden or sub acute onset of focal neurologic deficit, caused by the interruption of blood flow to parts of the brain. In this study, we aimed to investigate the prevalence of dyslipidemia and hyperglycemia among stroke patients in Palestine. Materials and Methods. A total of 70 patients with stroke were included in a cross-sectional study between November 2017 and February 2018. Stroke patients were diagnosed based on a CT scan reviewed by a neurologist. Fasting venous blood samples were collected to measure the lipid profile (cholesterol, low-density lipoproteins (LDL), triacylglycerol (TAG), high-density lipoproteins (HDL)), fasting blood glucose (FBG), and glycosylated hemoglobin (HbA1c) levels. An interview-based questionnaire, included background data, past medical history, family history, and other risk factors for stroke, was filled for each patient. Results. Based on our results, 28.57% of patients had high LDL, 17.1% had high cholesterol, 15.7% had high TAG and 61.3% had low HDL. About half of the patients (51.4%) had abnormal HbA1c and abnormal FBG (52.8%). The majority (67.1%) of patients were males, whereas, 11% of patients were obese (BMI of more than 30 kg/m2) and 51.4% were smokers. Regarding the family history of diseases, 81% of patients had a family history of hypertension, 50% had a family history of stroke, and 58% had a family history of diabetes mellitus. Conclusion. Male gender and smoking were most likely to increase the risk of stroke. Risk factors like low HDL, high LDL, high FBG, high HbA1c, and hypertension contribute substantially to the incidence of stroke. A family history of stroke, hypertension and diabetes were significant risk factors for stroke.

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