Title : SGLT2 inhibitors among ICU admitted acute stroke with T2DM patients a prospective cohort study in neuro cardio multispecialty hospital, Nepal
Abstract:
Poorly controlled diabetes is associated as cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes. SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria, and reduction of atrial fibrillation. No study has been documented in low-income countries to see the role of post stroke We aimed to study to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy as an oral hypoglycaemic agent. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital ICU protocol for stroke and comorbidities. Among 147 diabetic cases admitted to ICU 67 cases were started on the SGLT2 inhibitors whereas 68 were not treated with empagliflozin. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.
Audience Take Away Notes:
- SGLT2 inhibitors is safe to use in acute stroke at ICU as an add on anti-diabetic agents
- SGLT2 inhibitors is among acute stroke patient is associated with low mortality and better control of HbA1C
- More studies have to be done to know if the benefit of SGLT2 inhibitors is due to control of glycaemic index or beyond
