Prehospital exenatide in hyperglycemic stroke-A randomized trial

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Larsson , M , Castren , M , Lindström , V , von Euler , M , Patrone , C , Wahlgren , N & Nathanson , D 2019 , ' Prehospital exenatide in hyperglycemic stroke-A randomized trial ' , Acta Neurologica Scandinavica , vol. 140 , no. 6 , pp. 443-448 .

Title: Prehospital exenatide in hyperglycemic stroke-A randomized trial
Author: Larsson, Martin; Castren, Maaret; Lindström, Veronica; von Euler, Mia; Patrone, Cesare; Wahlgren, Nils; Nathanson, David
Contributor organization: HUS Emergency Medicine and Services
Department of Diagnostics and Therapeutics
University Management
Date: 2019-12
Language: eng
Number of pages: 6
Belongs to series: Acta Neurologica Scandinavica
ISSN: 0001-6314
Abstract: Objectives Hyperglycemia is a predictor for poor stroke outcome. Hyperglycemic stroke patients treated with thrombolysis have an increased risk of intracranial hemorrhage. Insulin is the gold standard for treating hyperglycemia but comes with a risk of hypoglycemia. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are drugs used in type 2 diabetes that have a low risk of hypoglycemia and have been shown to exert neuroprotective effects. The primary objective was to determine whether prehospital administration of the GLP-1RA exenatide could lower plasma glucose in stroke patients. Secondary objective was to study tolerability and safety. Materials & Methods Randomized controlled trial comparing exenatide administrated prehospitally with a control group receiving standard care for hyperglycemia. Patients with Face Arm Speech Test >= 1 and glucose >= 8 mmol/L were randomized. Glucose was monitored for 24 hours. All adverse events were recorded. Results Nineteen patients were randomized, eight received exenatide. An interim recruitment failure analysis with subsequent changes of the protocol was made. The study was stopped prematurely due to slow inclusion. No difference was observed in the main outcome of plasma glucose at 4 hours, control vs exenatide (mean, SD); 7.0 +/- 1.9 vs 7.6 +/- 1.6; P = .56). No major adverse events were reported. Conclusions We found no evidence that prehospital exenatide had effect on hyperglycemia. However, it was given without adverse events in this study with limited sample size that was prematurely stopped due to slow inclusion.
Subject: ambulances
diabetes mellitus
emergency medical services
glucagon-like peptide 1
3112 Neurosciences
3124 Neurology and psychiatry
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: acceptedVersion

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