Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been evaluated for cardiovascular and neurologic outcomes, including cognitive impairment, dementia, Parkinson’s disease, and cerebrovascular disease, with prior evidence suggesting reduced mortality. Whether these agents are associated with lower recurrence of cerebrovascular events in individuals with type 2 diabetes mellitus (T2DM) remains clinically relevant. A cohort study published in Diabetes & Vascular Disease Research evaluated the association between SGLT2 inhibitor use and recurrence of cerebrovascular events.

The study utilized data from the Korean National Health Insurance Service database and included adults aged 19 years or older diagnosed with T2DM. SGLT2 inhibitor users were compared with metformin users after 1:4 propensity score matching. Among the study population, 1563 individuals (7.8%) experienced recurrent cerebrovascular events. SGLT2 inhibitor use was associated with a lower risk of recurrent cerebral infarction compared with metformin (adjusted hazard ratio [aHR] 0.84; p = 0.010). When stratified by cerebrovascular subtype, ischemic stroke recurrence was significantly lower among SGLT2 inhibitor users (aHR 0.70; p = 0.020).

Within the SGLT2 inhibitor group, concurrent use of dipeptidyl peptidase-4 (DPP-4) inhibitors was associated with a reduced risk of cerebrovascular event recurrence (aHR 0.69; p = 0.011). These findings suggest an association between SGLT2 inhibitor therapy and lower recurrence of certain cerebrovascular events in adults with T2DM, indicating a potential role in secondary prevention.