Ischemic stroke and glucose intolerance: A review of the evidence and exploration of novel therapeutic targets

Stroke is one of the leading causes of death and disability worldwide. it is well known that hyperglycemia and/or diabetes potentially exacerbate the neuronal damage observed following ischemic stroke. recent reports have shown that hyperglycemia/glucose intolerance may be induced by cerebral ischemic stress,and that normalization of blood glucose levels during the first 48 h of hospitalization appears to confer greater survival outcomes in stroke patients. however,the mechanisms underlying post-ischemic glucose intolerance remain unclear. here,we review research to date on the mechanisms through which ischemic neuronal damage develops and on the role of post-ischemic glucose intolerance focusing on insulin and adiponectin signaling and communication between the brain and peripheral tissues. the relationship between ischemic neuronal damage and post-ischemic glucose intolerance is also discussed. with respect to therapeutic options,in addition to traditional post-stroke therapies,we also discuss the effect of anti-diabetic drugs and glucose-sensing neuropeptides on the development of the post-ischemic glucose intolerance and neuronal damage. in conclusion,we support the idea for focusing research on the development of post-ischemic glucose intolerance as a new therapeutic target for the stroke patients. © the japanese pharmacological society.