Introduction: Hyperglycemia found at arrival or after admission must be treated as soon as possible in acute stroke patients, because hyperglycemia impairs their clinical outcome. However, it hasn’t been established how to treat it.
Hypothesis: Sodium-glucose cotransporter-2 (SGLT2) inhibitors can lower blood glucose level soon and safely in an acute stroke stage.
Patients and Methods: We included acute stroke patients 1) who were admitted between September 2015 and June 2017, 2) who could orally take food after admission, 3) who presented fasting blood glucose level of higher than 150 mg/dl on the 3rd day, and 4) who received the SGLT2 inhibitor of luseogliflozin 2.5mg on the 3rd day to lower blood glucose level. We excluded patients undergoing enteral feeding or insulin therapy. We didn’t use sulfonylureas nor glinides. We provided food with appropriate calorie, determined according to Harris-Benedict equation, including carbohydrates (carbo) adjusted to 40% of the target calorie. We evaluated blood glucose level, urine glucose and urine ketones at arrival and on the 6th day.
Results: Fifty-six patients matched our criteria. On admission, their average age was 71 years, average body mass index was 24.1 kg/m2, their average HbA1c was 7.6 %, blood glucose level was 192 mg/dl and creatinine clearance was 64.6 ml/min. Patients take food with average 1400 kcal including carbo of 140 g/day. Average three days after starting luseogliflozin treatment, their average fasting blood glucose level was improved to 117 mg/dl, 54 patients (96%) presented positive urine glucose and 29 patients (52%) positive urine ketones. No symptoms of hypoglycemia or ketoacidosis occurred.
Conclusion: Luseogliflozin coupled with food including carbo of average 140 g/day could lower blood glucose level soon and safely in acute stroke patients with appropriate conditions.