Association of sodium-glucose linked transporter 2 inhibitors with functional outcomes at discharge in diabetic patients with acute ischemic stroke

ObjectiveTo investigate the association between the use of sodium-glucose linked transporter 2 (SGLT2) inhibitors and functional outcomes at discharge in diabetic patients with acute ischemic stroke (AIS).MethodsA retrospective cohort study was conducted using data from the Acute Stroke Patients for Stroke Management Quality Evaluation online database (CASE-Ⅱ, NCT04487340) for patients admitted between January 2022 and November 2024. Diabetic patients with AIS were categorized as SGLT2 inhibitor users or non-users (control group). Patients’ functional outcomes were assessed using the modified Rankin Scale (mRS) score. Propensity score matching (PSM) was performed in a 1∶2 ratio. Multivariate logistic regression models were used to assess the association between SGLT2 inhibitor use and outcomes. Stratified analyses were performed based on pre-existing diabetes versus newly diagnosed diabetes during the hospitalization and the impact of long-term and short-term use of SGLT2 inhibitors on patients’ functional outcomes at discharge was analyzed.ResultsThe study included 9220 patients (mean age 67±11 years; 39.38% female), of whom 1915 (20.77%) were SGLT2 inhibitor users. There were 1912 cases in the user group and 3683 cases in the non-user group after PSM. Before PSM, the proportion of patients with an mRS score 0-2 at discharge was significantly higher in the SGLT2 inhibitor group than that in the control group (79.84% vs. 69.19%, PPPConclusionAmong diabetic patients with AIS, SGLT2 inhibitor use is independently associated with better functional outcomes at discharge, showing a potential benefit for short-term neurological recovery.