Impact of pre-stroke metformin use on prognosis of Ischemic stroke; A pilot study

Abstract

Introduction: Ischemic stroke can arise from many atherosclerotic events including diabetes mellitus, a worldwide challenge now a day. Many factors have been shown to be effective on improvement of clinical prognosis in diabetic patients with stroke including good glucose control achieves most commonly by Metformin consumption. Metformin is shown previously to decrease the rate of incidence of stroke in diabetic patients, but its effect on clinical prognosis and severity of ischemic stroke in diabetic patients who involve by ischemic stroke has not been evaluated unless in a few researches, making the current research purpose. Method: 40 Diabetic patients who were involved by ischemic stroke were enrolled in our study according to inclusion and exclusion criteria, placed equally 20 patients in each of the groups of our research, the former consisted of diabetic patients who were under glucose control by Metformin and the latter consisted of diabetic patients who were receiving other medications else than Metformin. At the day of stroke and at the end of a three months course, while patients were continuing the previous antidiabetic medical regimens during this course, clinical outcome and severity of diabetic stroke patients evaluated by MRSA and NIHSS respectively. Results: results showed no statistically significant difference between Metformin consumers and non-consumers in both initial and final MRS scores, means that there is no correlation between Metformin consumption and a better prognosis in diabetic patients with stroke. RTPA consumption were of value for improvement in patients final MRS score means a more favorable outcome. Conclusion: Although Metformin therapy is known as a protective factor in diabetic patients decreasing the risk of ischemic stroke, probably by maintaining the normoglycemic state in patients, despite some previously performed studies results, here we have not found any clinically significant efficacy of Metformin in improvement of clinical outcome and lowering stroke severity in diabetic patients involved by ischemic brain stroke.