Prevent Stroke Recurrence in Diabetic Patients with Liraglutide
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on November 28th, 2025
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Individuals with diabetes face an elevated risk of ischemic stroke, and they are more likely to experience recurrent events. Prior research suggests that glycemic control alone-whether through insulin or sulfonylureas-does not fully account for this risk, indicating that additional mechanisms such as inflammation or insulin resistance may contribute to recurrence. With support from the Chinese government, researchers conducted a study to evaluate whether liraglutide could reduce the risk of stroke and transient ischemic attack (TIA) in patients with diabetes.
The phase 3 trial enrolled 636 participants with a mean age of about 64 years. All had either a low-risk acute ischemic stroke or a high-risk TIA. Low stroke risk was defined as a score of 3 or lower on the National Institutes of Health Stroke Scale, while high TIA risk was defined as an ABCD2 score of 4 or greater (with 7 as the highest severity). About 90% of participants had type 2 diabetes, and the median blood glucose at hospital admission was roughly 200 mg/dL. Approximately one-quarter had a prior ischemic stroke, and 3% had a previous TIA. Nearly all were receiving antithrombotic and lipid-lowering therapy.
Participants were randomly assigned to receive either liraglutide or placebo, administered subcutaneously. Liraglutide dosing began at 0.6 mg per day, increased to 1.2 mg in the second week, and reached a maintenance dose of 1.8 mg after the third week. Liraglutide is a GLP-1 receptor agonist commonly used to treat type 2 diabetes, with benefits for weight control, inflammation reduction, and cardiovascular protection.
After 90 days of treatment, the researchers found that daily subcutaneous injection with liraglutide reduced the risk of recurrent stroke by 44%. Subgroup analyses showed that this benefit was most pronounced in men younger than 65 years with a body mass index under 25. The reduced risk of ischemic stroke may be linked to the ability of GLP-1 receptor agonists to inhibit platelet aggregation through activation of platelet cyclic adenosine monophosphate and endothelial nitric oxide synthase pathways, ultimately limiting thrombus formation.
The phase 3 trial enrolled 636 participants with a mean age of about 64 years. All had either a low-risk acute ischemic stroke or a high-risk TIA. Low stroke risk was defined as a score of 3 or lower on the National Institutes of Health Stroke Scale, while high TIA risk was defined as an ABCD2 score of 4 or greater (with 7 as the highest severity). About 90% of participants had type 2 diabetes, and the median blood glucose at hospital admission was roughly 200 mg/dL. Approximately one-quarter had a prior ischemic stroke, and 3% had a previous TIA. Nearly all were receiving antithrombotic and lipid-lowering therapy.
Participants were randomly assigned to receive either liraglutide or placebo, administered subcutaneously. Liraglutide dosing began at 0.6 mg per day, increased to 1.2 mg in the second week, and reached a maintenance dose of 1.8 mg after the third week. Liraglutide is a GLP-1 receptor agonist commonly used to treat type 2 diabetes, with benefits for weight control, inflammation reduction, and cardiovascular protection.
After 90 days of treatment, the researchers found that daily subcutaneous injection with liraglutide reduced the risk of recurrent stroke by 44%. Subgroup analyses showed that this benefit was most pronounced in men younger than 65 years with a body mass index under 25. The reduced risk of ischemic stroke may be linked to the ability of GLP-1 receptor agonists to inhibit platelet aggregation through activation of platelet cyclic adenosine monophosphate and endothelial nitric oxide synthase pathways, ultimately limiting thrombus formation.