Stroke in the patient with diabetes (Part 2) - Prevention and the effects of glucose lowering therapies.

Abstract:

:There is a higher incidence of stroke in both the type 2 diabetic and the non-diabetic insulin resistant patient which is accompanied by higher morbidity and mortality. Stroke primary prevention can be achieved by controlling atrial fibrillation and hypertension, and the utilization of statins and anticoagulant therapies. Utilizing pioglitazone and GLP-1 receptor agonists reduce the risk of stroke while the utilization of metformin, α-glucosidase inhibitors, DPP-4 and SGLT-2 inhibitors have no effect. Insulin use may be a marker of increased risk of stroke, but not necessarily causative. Utilizing intravenous insulin to normalize plasma glucose levels in the acute phase of a stroke does not improve the outcome. Antiplatelet agents are not proven to be of benefit in primary prevention whereas the use of direct-acting oral anticoagulants to avoid stroke and the early use of tpA in the acute phase have been shown to be beneficial.

authors

Bell DSH,Goncalves E

doi

10.1016/j.diabres.2020.108199

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

108199

eissn

0168-8227

issn

1872-8227

pii

S0168-8227(20)30449-6

journal_volume

164

pub_type

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