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Updated: Mar 25, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Rationale and design of Short-Term EXenatide therapy in Acute ischaemic Stroke (STEXAS): a randomised, open-label,
Rachel T McGrath1, Samantha L Hocking2, Miriam Priglinger3
1Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, Sydney, New South Wales, Australia University of Sydney, Northern Clinical School, Sydney, New South Wales, Australia Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Exenatide, a GLP-1 analogue, may help manage high blood glucose in acute ischemic stroke (AIS) patients, potentially reducing hypoglycemia risk compared to insulin. This pilot study assesses its efficacy and feasibility in AIS hyperglycemia management.
Area of Science:
- Neuroscience
- Endocrinology
- Cardiovascular Medicine
Background:
- Hyperglycemia and hypoglycemia in acute ischemic stroke (AIS) correlate with larger infarcts and poorer outcomes.
- Maintaining normoglycemia during stroke is crucial for patient recovery.
- Glucagon-like peptide 1 (GLP-1) analogues are established treatments for type 2 diabetes hyperglycemia, but their role in AIS is under-researched.
Purpose of the Study:
- To investigate the efficacy of exenatide in lowering blood glucose levels in AIS patients with hyperglycemia.
- To assess the feasibility of administering intravenous exenatide in this patient population.
- To evaluate the incidence of hypoglycemia and neurological outcomes post-stroke.
Main Methods:
- A randomized, open-label, parallel-group pilot study involving 30 patients with AIS and blood glucose >10 mmol/L.
- Participants received either standard therapy (intravenous insulin) or intravenous exenatide for up to 72 hours.
- Outcomes included achieving target blood glucose (5-10 mmol/L), hypoglycemia incidence, and 3-month neurological assessment.
Main Results:
- Pilot study data on exenatide's efficacy in lowering blood glucose in AIS patients are limited.
- The study aims to assess blood glucose control within the target range (5-10 mmol/L).
- Feasibility and safety of intravenous exenatide administration will be evaluated.
Conclusions:
- Exenatide's glucose-dependent action may minimize hypoglycemia risk in AIS patients.
- This could offer a safer alternative to intensive insulin therapy for acute hyperglycemia management in stroke.
- Potential long-term benefits in reducing morbidity and mortality for AIS patients.
