Impact of glibenclamide versus Insulin on neurological and functional outcomes of hemorrhagic stroke in diabetic patients

ABSTRACT

Background & Objective: Stroke is one of the common leading causes of morbidity and mortality worldwide. Diabetes is one of the modifi able risk factors of stroke which is related to a higher mortality and a poorer outcome. We aimed to evaluate the protective effect of Insulin versus glibenclamide on the improvement of neurological and functional outcomes of hemorrhagic stroke. Methods: The present single blind clinical trial was conducted on 100 patients with stroke and diabetes who had referred to Neurology Emergency Department of Vali-e-Asr hospital, Arak, Iran. The patients were categorized into two groups according to the glucose control treatment before stroke. Without any randomization, glibenclamide was used in 45 patients, while others (55 ones) received insulin. National Institute of Health Stroke Scale (NIHSS) and modifi ed Rankin scale (MRS) systems were used for evaluating the neurological and functional outcomes. Results: Hemiparesis was the most common sign of the patients. The mean of changes in NIHSS and MRS scores of the two groups were -29.69±21.4 and -17.24±21, respectively. Although Insulin group had a higher decrease in NIHSS and MRS scores, no signifi cant difference was found between the two groups. Both treatment methods had a signifi cant decreasing effect on NIHSS and MRS scores (p<0.001). Conclusion: Patients treated with both glibenclamide and insulin had similar decrease in their one week NIHSS and MRS scores with no signifi cant difference in the two treatment groups.