A recent study published in the Journal of Clinical Neuroscience highlighted the role of Sulfonylureas (SUs) in patients with severe stroke and type 2 diabetes (T2D). The study aimed to determine the association of SUs and short-term mortality in patients. 

Adults (n=1366) with severe ischemic stroke and T2D were selected from a retrospective cohort analysis of MIMIC-IV ICU admissions who were exposed to SUs within 7 days of stroke onset. Malignant edema intervention and 30-day all-cause mortality were the primary outcomes. By multivariable Cox regression and Kaplan–Meier curves, the mortality was determined with  1:1 inverse probability of treatment weighting and propensity score matching. Using the Fine–Gray competing-risks cumulative incidence function model, malignant edema was assessed. 

It was found that the 30-day all-cause mortality was 7.1% versus 22.4%. A reduction in 30-day death risk by 57% due to SUs was also observed, which was confirmed by IPTW (HR 0.38; 95% CI 0.18–0.84; p = 0.02) and propensity matching (HR 0.24; 95% CI 0.07–0.81; p = 0.02). 

Pre-matching (sHR 0.41), becoming significant after matching (sHR 0.32) for malignant-edema intervention. SUs showed a decline in 90-day and 1-year mortality with no hypoglycemia.