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Metformin 500 mg daily improves neurological recovery in non-diabetic patients with acute ischemic stroke.
Metformin, widely used for diabetes management, illustrates powerful neuroprotective effects in non-diabetic patients with acute ischemic stroke, according to a double-blind randomized clinical trial evaluating functional recovery over 3 months.
Overall, 70 non-diabetic patients with imaging-confirmed acute ischemic stroke (computed tomography [CT] or magnetic resonance imaging [MRI]) were enrolled within 24 hours of symptom onset. Volunteers were randomly allocated to receive metformin 500 mg once daily or a placebo for 3 months alongside standard stroke care.
Neurological status was assessed via the National Institutes of Health Stroke Scale (NIHSS), with sub-scores categorized as no deficit (0), mild (1), moderate (2), or severe (3) to account for stroke heterogeneity. Motor, sensory, facial, visual, and gaze functions were determined at baseline, 1 month, 2 months, and 3 months. Safety monitoring was executed throughout the study.
Metformin produced remarkable improvements in overall National Institutes of Health Stroke Scale (NIHSS) scores at 2 months (P = 0.021) and 3 months (P = 0.003) when compared with placebo. The most notable recovery was observed in facial, motor, sensory, and visual domains, while best gaze remained normal in most volunteers. Importantly, no serious adverse events were reported, and only 2 patients (5.7%) in the metformin group experienced mild gastrointestinal symptoms, confirming favorable tolerability.
Thus, metformin 500 mg daily for 3 months is safe and remarkably enhances neurological recovery in non-diabetic acute ischemic stroke patients. The findings reinforce growing evidence supporting metformin’s neuroprotective, anti-inflammatory, and functional recovery benefits beyond glycemic control.
Galen Medical Journal
Effect of Metformin on Clinical Course of Non-Diabetic Patients with Ischemic Stroke
Behnaz Behbudi et al.
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