Heijmans, E.M. (2021) Association between metformin use and functional outcome after ischemic stroke in patients with type 2 diabetes mellitus. thesis, Medicine.
Full text available on request.Abstract
Background: ischemic stroke is a serious condition with high morbidity (and mortality). Patients with type 2 diabetes mellitus (DM) have an increased risk of a more severe impaired functional outcome after ischemic stroke. These patients could benefit from a neuroprotective agent. Growing evidence suggests that metformin, besides its hypoglycemic effects, reduces stroke severity and improves functional outcome due to neuroprotective properties. This study analyzes the effects of metformin use on functional outcome and stroke severity in type 2 DM patients with ischemic stroke. Methods: a retrospective cohort study was conducted. The study population consisted of type 2 DM patients admitted to the stroke unit of the Medisch Spectrum Twente, Enschede, with a first-ever ischemic stroke between January 2017 and May 2021. Primary outcome measure was functional outcome, measured with mRS. Secondary outcome measure was initial stroke severity, measured with NIHSS. Metformin monotherapy was subsequently compared with metformin combined therapy. Results: a total of 453 patients was included in the study. Of these patients, 297 used metformin. Metformin use was not associated with initial stroke severity (baseline NIHSS 3 IQR 2 – 7, P = 0.20). Metformin use was related to favorable outcome: OR 1.54 (95% CI 1.04 – 2.27). Metformin combined therapy compared with monotherapy was associated with a lower NIHSS score compared to monotherapy, with a regression coefficient of -1.54 (95% CI: -2.89 – -0.19), and a higher percentage of mild stroke: OR 2.24 (95% CI: 1.36 – 3.86). Conclusion: metformin use is associated with better functional outcome after ischemic stroke in patients with a history of type 2 DM. Metformin combined therapy is associated with decreased stroke severity.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Knottnerus, dr. I.L.H. and Kersten, C.J.B.A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 10:41 |
| Last Modified: | 07 Jan 2022 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3000 |
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