GLP-1 agonists reduce risk of Stroke and provide neuroprotection to diabetes patients

Neuroprotective effects of glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors are independent of glycemic control, says an article published in Journal of Diabetes and its Complications. 

Stroke accounts for 11.6% of all fatalities globally, making it the second leading cause of death. In 2019, there were about 6.55 million stroke-related fatalities, 12.2 million incident cases, and 101 million prevalent cases. Stroke risk is often increased in diabetic patients. In recent years, new glucose-lowering medications have been launched, and randomized controlled trials (RCTs) have shown the varied effects of these medications on cardiovascular end events. Jiaxi Li and his colleagues did a meta-analysis to incorporate these trials, which employed SGLT-2 inhibitors, GLP-1 agonists, or DPP-4 inhibitors in the experimental group and placebo in the control group to evaluate the influence on the risk of stroke in people with type 2 diabetes.

Studies having stroke as an outcome event up to 3 December 2021 were found through searches of the Embase, Cochrane Library, and PubMed databases. A fixed-effects model was used to examine risk ratios for outcomes related to stroke.

The key findings of this study were:

19 RCTs involving 155 027 type 2 diabetic individuals were discovered. 

According to a pooled analysis, GLP-1 agonists decreased total stroke (RR = 0.84, 95%CI 0.77-0.93, P = 0.000, I2 = 0%) and non-fatal stroke (RR = 0.85, 95%CI 0.77-0.94, P = 0.002, I2 = 0%) by 16% and 15%, respectively, compared to placebo. 

Neither SGLT-2 inhibitors nor DPP-4 inhibitors were substantially linked to a reduced risk of stroke.

In conclusion, if GLP-1 agonists are to be utilized to lower the risk of stroke in people with type 2 diabetes, more research is required. Additionally, more study is required to determine how various stroke subtypes are affected by novel glucose-lowering medications.

Reference: 

Li, J., Ji, C., Zhang, W., Lan, L., & Ge, W. (2023). Effect of new glucose-lowering drugs on stroke in patients with type 2 diabetes: A systematic review and Meta-analysis. In Journal of Diabetes and its Complications (Vol. 37, Issue 1, p. 108362). Elsevier BV. https://doi.org/10.1016/j.jdiacomp.2022.108362