OBJECTIVES: Type 2 diabetes (T2D) is a known risk factor for stroke, particularly for ischemic stroke. The aim of this study was to describe the healthcare resource use (HCRU) and economic burden of stroke among people with T2D in France.

METHODS: A retrospective observational study was performed using data from a representative sample of the French population derived from the national healthcare database SNDS. Index date was defined as the first stroke hospitalization date among prevalent adult people with T2D from 1 January 2012 to 31 December 2018. HCRU and costs were evaluated from index date until 31 December 2019.

RESULTS: Overall, among 45,331 prevalent people with T2D, 2090 had an incident stroke hospitalization (4.6%). Mean (Standard Deviation) age at index date was 75.0 (11.4) years and 55.3% were male. Ischemic stroke was most frequent (75.7%), followed by hemorrhagic (15.6%) and unspecified (8.7%) stroke. During a median of 2.4 years of follow-up, the subsequent hospitalization rate was 2.2 per patient per year (PPPY; 3.1 PPPY for hemorrhagic stroke patients and 1.9 PPPY for ischemic stroke patients). Overall, 30-day mortality was 16.3% (35.4% and 12.4% for hemorrhagic stroke and ischemic stroke patients, respectively). Median (Interquartile Range Q1-Q3; IQR) hospital cost was €5,683 (2,634-11,292) PPPY. Median (IQR) outpatient cost, including visits, treatments, and procedures, was €4,890 (1,599-11,316) PPPY. Total median (IQR) cost was €12,199 (6,846-22,378) PPPY, with similar figures by type of stroke (€11,947 [6,851-21,764] and €11,985 [6,236-21,753] for hemorrhagic and ischemic stroke, respectively).

CONCLUSIONS: The economic burden of stroke among T2D patients is high in France. Whilst hemorrhagic stroke patients tend to present with more severe clinical outcomes compared to ischemic stroke patients, the total cost of stroke in T2D patients was driven in a substantial proportion by the high frequency of ischemic stroke patients.