INTRODUCTION: Contemporary estimates of the impact of type 2 diabetes (T2D) on stroke outcomes are important for care planning and resource allocation. This retrospective cohort study compared the incidence of stroke and subsequent clinical and economic outcomes following stroke among people with and without T2D. PATIENTS AND METHODS: Data were extracted from a subset of the French Système National des Données de Santé database. Stroke incidence as well as post-stroke clinical outcomes, healthcare resource utilization (HCRU), use of stroke preventative treatments, and costs were compared among people with and without T2D. RESULTS: The study included 10,906 patients hospitalized for stroke including 2141 (19.6%) people with T2D. Age-standardized stroke incidence rates were 3.3 (95% confidence interval [CI] 3.1
3.6) per 1000 person-years and 2.2 (2.1
2.3) in people with and without T2D, respectively. Patients with T2D had significantly higher risk of stroke recurrence (adjusted hazard ratio [HR] 1.14, 95% CI: 1.01
1.30) and mortality (HR 1.16, 95% CI: 1.08
1.25) than patients without T2D. The proportion of patients with T2D treated with statins decreased from 27.3% pre-stroke to 20.6% post-stroke but remained relatively stable among patients without T2D (from 13.4% to 13.1%). The mean healthcare costs in the 12 months following stroke were higher among patients with T2D than those without (€22,635 vs €18,629). DISCUSSION AND CONCLUSION: The incidence and clinical and economic burden of stroke is considerably higher among people with T2D. Further efforts are needed to reduce this disparity.