Effects of glucose-lowering agents on ischemic stroke

Table 1 Effects of antidiabetic agents on glucose levels, other cardiovascular risk factors and ischemic stroke

Agent	Glucose-lowering efficacy	Other favorable effects	Effect on ischemic stroke
Metformin	High	Weight loss	Decrease
Sulfonylureas	High	(-)	No effect
Thiazolidinediones Pioglitazone	High	Reduction in triglyceride levels	Might reduce the risk of recurrent stroke
DPP-4 inhibitors (1) Alogliptin, saxagliptin, sitagliptin (2) Linagliptin	Moderate	None	No effect Reduction (?)
GLP-1 agonists (1) Liraglutide, lixisenatide (2) Semaglutide	High	Weight loss and blood pressure reduction	No effect Reduction
SGLT-2 inhibitors Empagliflozin	Moderate	Weight loss and blood pressure reduction	No effect

DPP: Dipeptidyl peptidase; GLP: Glucagon-like peptide; SGLT: Sodium-glucose cotransporter.