Risk factors for stroke in type 2 diabetes mellitus.

Stroke is a serious complication of diabetes but the risk factors for stroke in these patients are not fully defined. The aim of this retrospective study was to investigate the risk factors for stroke in patients with type 2 diabetes mellitus (T2DM). The group comprised 208 patients with T2DM, and the mean duration of follow-up was seven years (range 4-11 years). The incidence of stroke was investigated according to lymphocyte proliferation in response to insulin. Using cimetidine to inhibit cells with histamine receptors and indometacin to inhibit prostaglandin-synthesising cells, a higher incidence of stroke was found in patients with indirect cell-mediated immunity to insulin. Therefore, one of the risk factors for stroke in patients with T2DM is high activity of cells with histamine receptors and prostaglandin-synthesising cells. These cells suppress cell-mediated immunity to insulin and may have a role in promoting the development of insulin resistance.