Age-specific rate of undiagnosed diabetes and prediabetes in acute stroke

Aims: We investigated age-specific rates of undiagnosed diabetes and prediabetes among patients with acute stroke. Methods: We used data from 2223 patients with acute stroke consecutively admitted to an Italian Stroke Unit (SU) between 2010 and 2015. Information from medical records and glycated hemoglobin (HbA1c) measured on admission was retrospectively used to screen for diabetes and prediabetes defined according to standard criteria. Results: Overall rate of diabetes undiagnosed at admission and diabetes still undiagnosed at SU discharge were 9.7% and 6.7% but age-specific prevalence peaked up to 12.0% and 9.0% after age 80. At admission, the proportion of all undiagnosed diabetes on total diabetes cases was one out of every two cases before age 60 and three out of every four cases after age 80. In these same age intervals, one out of every three diabetes cases was still undiagnosed at SU discharge. Regardless of age, about three out of ten patients with acute stroke had prediabetes. Less than 2% of these patients had a prediabetes diagnosis before or after SU admission. Conclusions: In patients with acute stroke, diabetes is substantially underdiagnosed before age 60 and after age 80. Prediabetes is highly prevalent but mostly undiagnosed at all ages. (C) 2019 Elsevier B.V. All rights reserved.