Stroke prevention in patients with type 2 diabetes mellitus or prediabetes: recommendations of the Spanish Society of Neurology’s Stroke Study Group

Fuentes, Blanca; Amaro, Sergio; Leciñana, M. Alonso de; Arenillas, Juan F.; Ayo-Martín, Óscar; Freijó, Marimar; García-Pastor,; Gomis, Meritxell; Gómez-Choco, Manuel; López‐Cancio, Elena; Martínez-Sánchez, Patricia; Morales, A.; Palacio-Portilla, E.J.; Rodríguez‐Yáñez, Manuel; Roquer, Jaume; Segura, Tomás; Serena, Joaquı́n; Vivancos-Mora, J

doi:10.1016/j.nrleng.2020.04.022

Cited by 6 publications

(13 citation statements)

References 92 publications

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“…Given the available evidence supporting the use of GLP-1RAs to reduce the risk of stroke among those living with T2D and the corresponding recommendations from various guidelines, we believe it is important for neurologists to consider GLP-RAs in appropriate patients. While we concur with the Spanish Society of Neurology that a secondary prevention study following participants with T2DM and a stroke history is warranted to provide more robust data on the utility of GLP-1RAs for prevention of stroke recurrence in T2DM, 9 we deem the lack of heterogeneity for stroke reduction in REWIND and SUSTAIN-6 for the subgroups with prior stroke/TIA and prior MI/stroke respectively as sufficient evidence to recommend dulaglutide or semaglutide for stroke reduction in those with prior stroke. This aligns with the recommendations of other groups.…”

Section: Interventions For Stroke Reduction In Type 2 Diabetessupporting

confidence: 57%

“…9 However, among those without a prior stroke history, thiazolidinediones are not recommended for stroke prevention in T2DM. 9…”

Section: Interventions For Stroke Reduction In Type 2 Diabetesmentioning

confidence: 99%

“…Current stroke prevention guidelines 7–9 recommend the use of GLP-1RAs (glucagon-like peptide 1 receptor agonists), a newer class of antihyperglycemic agents that reduce the risk of stroke in people with T2DM. The addition of the GLP-1RAs to the neurology toolkit offers an original and exciting opportunity to obtain a meaningful impact on stroke.…”

Section: Glycemia Type 2 Diabetes and Strokementioning

confidence: 99%

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Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists

Goldenberg

Cheng

Fitzpatrick

et al. 2022

Stroke

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People living with diabetes are at higher risk for stroke and have a poorer prognosis following a stroke event than those without diabetes. Data from cardiovascular outcome trials and meta-analyses indicate that GLP-1RAs (glucagon-like peptide 1 receptor agonists) reduce the risk of stroke in individuals with type 2 diabetes. Accordingly, many guidelines now recommend the addition of GLP-1RAs to ongoing antihyperglycemic regimens to lower the risk of stroke in type 2 diabetes. The current work summarizes evidence supporting the use of GLP-1RAs for stroke reduction in people with type 2 diabetes and offers 2 new resources for neurologists who are considering GLP-1RAs for their patients—a list of frequently asked questions with evidence-based answers on safely initiating and managing GLP-1RAs, and a practical decision-making algorithm to assist in using GLP-1RAs as part of a stroke reduction strategy.

show abstract

Section: Interventions For Stroke Reduction In Type 2 Diabetessupporting

confidence: 57%

“…9 However, among those without a prior stroke history, thiazolidinediones are not recommended for stroke prevention in T2DM. 9…”

Section: Interventions For Stroke Reduction In Type 2 Diabetesmentioning

confidence: 99%

Section: Glycemia Type 2 Diabetes and Strokementioning

confidence: 99%

See 1 more Smart Citation

Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists

Goldenberg

Cheng

Fitzpatrick

et al. 2022

Stroke

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“…Research on the role of other anti‐DM medications, such as GLP‐1 agonists, SGLT2 inhibitors and DPP‐4 inhibitors, have generally shown either non‐significant benefit or mixed results and are not routinely recommended as a stroke prevention tool 96,161–164 . Recommendations, published in 2020 from the Cerebrovascular Diseases Study Group of the Spanish Society of Neurology, indicated the benefit of GLP‐1 agonists and pioglitazone, when added to conventional therapy, in primary and secondary prevention of stroke respectively 165 . Control of risk factors, such as hypertension, cholesterol, blood pressure, smoking and weight management, is recommended 166,167 …”

Section: Resultsmentioning

confidence: 99%

“…96,[161][162][163][164] Recommendations, published in 2020 from the Cerebrovascular Diseases Study Group of the Spanish Society of Neurology, indicated the benefit of GLP-1 agonists and pioglitazone, when added to conventional therapy, in primary and secondary prevention of stroke respectively. 165 Control of risk factors, such as hypertension, cholesterol, blood pressure, smoking and weight management, is recommended. 166,167 3.4.2 | Acute stroke phase (managing acute hyperglycaemic events)…”

Section: Pre-stroke Phase (Prophylaxis)mentioning

confidence: 99%

Role of diabetes in stroke: Recent advances in pathophysiology and clinical management

Bradley

Spring

Beran

et al. 2021

Diabetes Metabolism Res

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The increasing prevalence of diabetes and stroke is a major global public health concern. Specifically, acute stroke patients, with pre-existing diabetes, pose a clinical challenge. It is established that diabetes is associated with a worse prognosis after acute stroke and the various biological factors that mediate poor recovery profiles in diabetic patients is unknown. The level of association and impact of diabetes, in the setting of reperfusion therapy, is yet to be determined. This article presents a comprehensive overview of the current knowledge of the role of diabetes in stroke, therapeutic strategies for primary and secondary prevention of cardiovascular disease and/or stroke in diabetes, and various therapeutic considerations that may apply during pre-stroke, acute, sub-acute and post-stroke stages. The early diagnosis of diabetes as a comorbidity for stroke, as well as tailored post-stroke management of diabetes, is pivotal to our efforts to limit the burden. Increasing awareness and involvement of neurologists in the management of diabetes and other cardiovascular risk factors is desirable towards improving stroke prevention and efficacy of reperfusion therapy in acute stroke patients with diabetes.

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N-methyladenosine modification in ischemic stroke: Functions, regulation, and therapeutic potential

Han

2024

Heliyon

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Stroke prevention in patients with type 2 diabetes mellitus or prediabetes: recommendations of the Spanish Society of Neurology’s Stroke Study Group

Cited by 6 publications

References 92 publications

Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists

Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists

Role of diabetes in stroke: Recent advances in pathophysiology and clinical management

N-methyladenosine modification in ischemic stroke: Functions, regulation, and therapeutic potential

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