Journal Article

Effect of metformin on the clinical outcomes of stroke in patients with diabetes: a systematic review and meta-analysis

Wen, Jun, Luo, Fuqun, Li, Yandeng, Zhu, Jianming, Huang, Zhihua, Liu, Jianyi, Guo, Yizhi

2025

Overview

ObjectivesStroke is a major cause of death and disability globally, especially among diabetic patients. In this study, we aim to scrutinise the effects of metformin on the clinical outcomes of stroke in diabetic patients.DesignThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesPubMed, Embase and Web of Science databases were searched between their inception and 5 December 2023.Eligibility criteria for selecting studiesStudies investigating the effect of metformin on the clinical outcomes of stroke in patients with diabetes were included.Data extraction and synthesisThe effect of metformin on the clinical outcomes of stroke in patients with diabetes was identified using combined ORs and 95% CIs.ResultsA total of 11 studies involving 18 525 participants were included in this review. Pooled analysis has demonstrated that prestroke metformin use could reduce the probability of poor course after stroke by 34% in diabetes mellitus (DM) patients (OR=0.66, 95% CI: 0.61 to 0.72) and reduce the probability of death by 43% (OR=0.57, 95% CI: 0.51 to 0.64).ConclusionsPrestroke metformin use is beneficial for the improvement of clinical outcomes in patients who had a stroke with DM, although the potential bias should be carefully considered.PROSPERO registration numberCRD42024496056.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Antidiabetics / Clinical outcomes / Cohort analysis / Diabetes / Diabetes Mellitus - drug therapy / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - drug therapy / Fatalities / Humans / Hypoglycemic Agents - therapeutic use / Ischemia / Medical prognosis / Meta-Analysis / Metabolism / Metformin - therapeutic use / Mortality / Neurology / Original Research / Patients / Prognosis / Stroke / Stroke - complications / Stroke - drug therapy / Stroke - mortality / Stroke - prevention & control / Treatment Outcome