Effects of glucose-lowering agents on ischemic stroke

作     者：Konstantinos Avgerinos Konstantinos Tziomalos 

作者机构：First Propedeutic Department of Internal MedicineMedical SchoolAristotle University of ThessalonikiAHEPA Hospital54636 ThessalonikiGreece 

出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)

年 卷 期：2017年第8卷第6期

页      面：270-277页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100204[医学-神经病学] 10[医学] 

主　　题：Antidiabetic treatment Ischemic stroke Cardiovascular events Glucose regulation Neuroprotection 

摘      要：Diabetes mellitus(DM) is a major risk factor for cardiovascular events, including ischemic stroke. Moreover, ischemic stroke appears to be more severe in these patients and to be associated with less favorable outcomes. However, strict glycemic control does not appear to reduce the risk of ischemic stroke. On the other hand, newer glucose-lowering agents(glucagon-like peptide 1 receptor agonists and sodiumglucose cotransporter 2 inhibitors) reduced the risk of cardiovascular events in recent randomized, placebocontrolled trials. Semaglutide also reduced the risk of ischemic stroke. These benefits are independent of glucose lowering and might be due to the favorable effects of these agents on body weight and blood pressure. Pioglitazone also reduced the risk of recurrent stroke in patients with insulin resistance or type 2 DM but the unfavorable safety profile limits its use. In contrast, sulfonylureas and dipeptidyl peptidase 4 inhibitors have a neutral effect on cardiovascular morbidity and might be less attractive options in this high-risk population.