Abstract
Impaired glucose tolerance is a high-risk illness which may develop in diabetic patients, and abnormal glucose metabolism including impaired glucose tolerance is a risk factor of ischemic stroke as well as diabetes. Screening using 75-gram oral glucose tolerance test (OGTT) was useful in identifying disorders of glucose metabolism in ischemic stroke patients with no history of diabetes. A significantly large percentage of patients with ischemic stroke and no history of diabetes were found to have newly diagnosed abnormal glucose metabolism and insulin resistance by OGTT. It is the present conditions that lack scientific evidence concerning prevention for the onset and recurrence of stroke by the adjustment of blood glucose level. In ischemic stroke patients with abnormal glucose metabolism, the intervention of insulin resistance and postprandial hyperglycosemia for the purpose of suppression against the progression of atherosclerosis is a choice in the preventive cure for the recurrence of ischemic stroke. Glucagon-like peptide-1 receptor (GLP-1) agonist, exendin-4, can protect against oxidative products and neuronal cell death caused by ischemic brain damage. Exendin-4 treatment increased intracellular cAMP levels. Activation of the cAMP response could mediate GLP-1-induced brain protection in cerebral ischemia.
