Journal of Stroke and Cerebrovascular Diseases · Oct 25, 2026

Sex- and Age-Specific Descriptive Patterns in Ischemic Stroke Incidence and Mortality Among Patients with Type 2 Diabetes: A Nationwide Cohort Study (2000-2018)

By Ko FS, Yen FS, Wei JC et al.

BACKGROUND: Despite global advancements in stroke prevention, it remains unclear if benefits are shared equally. This study investigates intersectional descriptive patterns in ischemic stroke incidence and 30-day mortality among patients with type 2 diabetes (T2D) in Taiwan, focusing on sex-specific temporal trends. METHODS: We analyzed data from the National Health Insurance Research Database in Taiwan. Using propensity score matching, we compared outcomes between patients with and without T2D. Cox proportional-hazard models were employed to assess risks, stratified by sex and age to identify specific vulnerable populations. RESULTS: The absolute incidence of ischemic stroke declined substantially between 2000 and 2018 in both patients with T2D (from 102.50 to 38.52 per 10,000 person-years) and those without T2D (from 40.14 to 17.81 per 10,000 person-years). Despite these reductions, patients with T2D consistently had higher incidence rate-based relative risk of ischemic stroke than those without T2D. In women, the relative risk increased to 2.86 during 2015-2018. Among participants younger than 60 years, both absolute incidence and the corresponding risk estimates decreased over time, whereas the relative risk remained persistently elevated among older participants. Absolute 30-day mortality also declined markedly in both groups, although women with T2D exhibited an increased relative mortality risk during the most recent recruitment period (2015-2018). CONCLUSIONS: While overall stroke incidence in Taiwan has declined, temporal progress varies by age and sex. Relative stroke risk has narrowed among younger individuals but remained stable or descriptively higher among elderly women with diabetes. Further research is needed to clarify underlying mechanisms and guide tailored prevention strategies.

doi.org/10.1016/j.jstrokecerebrovasdis.2026.108774Open accessPubMed 42927802Populations