Safe and Quick Control of Hyperglycemia with Luseogliflozin in Case of High-Dose Intensive Insulin User in an Acute Ischemic Stroke Stage: A Case Report

Introduction: Diabetes mellitus is one of major risk factors of stroke and it hasn't been established how to manage hyperglycemia safely and quickly in an acute stroke stage, particularly in cases of high-dose insulin users. Case Presentation:A 62-year-old female undergoing high-dose intensive insulin therapy presented with numbness of the right hand.On arrival, serum glucose level was 282 mg/dl and HbA1c 12.8%, although she had daily used total dose of 66 units of insulin.Luseogliflozin, one of sodium-glucose cotransporter-2 (SGLT2) inhibitors, coupled with mild low-carbo diet started under insulin degludec of 10 units.Her fast blood glucose became 73 mg/dl in one week and discharged home.Conclusion: Luseogliflozin coupled with mild low-carbo diet controlled hyperglycemia safely in an acute stroke stage.Keywords: Hyperglycemia; Luseogliflozin; Acute ischemic stroke on arrival, this was because she had eaten carbohydrates too much every day.Therapy she had undergone was unsuccessful in managing blood glucose level and in preventing micro-and macro-angiopathy.Immediately after hospitalization, mild low-carbo diet (1,400 kcal per day and 140 g of carbohydrates per day) started under LAI degludec of 10 units to control blood glucose level and luseogliflozin 2.5 mg, one of sodium-glucose cotransporter-2 (SGLT2) inhibitors was added on the 4th day (Figure 1).Intake of carbohydrates was 50 g at breakfast, 50 g at lunch and 40 g at dinner and she finally had 2 units of UFAI glulisine before breakfast and lunch as carbohydrate counting method.