Short-Term Exenatide Therapy in Acute Ischaemic Stroke - A Randomised, Open-Label, Parallel-Group Study

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As hyperglycaemia in acute ischaemic stroke is associated with increased infarct size and worse functional outcomes, therapies that can maintain normoglycaemia during stroke are of significant clinical importance. GLP-1 analogues, including exenatide, are a potential therapeutic option for the effective regulation of blood glucose levels in acute stroke, without the risk of inducing hypoglycaemia, which can be associated with intensive insulin therapy. GLP-1 therapy is more straightforward to implement and does not require dose adjustment over time, as is necessary for intensive insulin therapy. This may result in less of a burden on treating clinical staff. Furthermore, administration of GLP-1 may have direct beneficial effects on neuronal cell survival and result in neuroprotection, as suggested by animal studies and preliminary clinical data. Thus, the use of a GLP-1 receptor agonist in the management of hyperglycaemia in acute ischaemic stroke (AIS) may confer a benefit in morbidity and mortality for patients long-term.