Abstract TP202: Quality Improvement Project of Increasing Utilization of Antihyperglycemic Medications with Cardiovascular Benefits in Patient with Diabetes admitted with Acute Ischemic Stroke

Introduction: Emerging evidence supports the notion that SGLT2 inhibitors and GLP-1 receptor agonists provide significant benefits in patients with type 2 diabetes (T2D), beyond their glucose-lowering effects. However, the utilization of these drugs in clinical practice remains suboptimal. Methods: Using the Plan-Do-Study-Act quality improvement methodology, a multidisciplinary team was assembled to identify strategies to increase the use of SGLT2i and GLP1R agonists in patients with T2D admitted to the University of Illinois Health (UIH) hospital for acute ischemic stroke. For any inpatient with T2D and an HbA1c ≥7%, a consultation with the Endocrinology Team was initiated. The Endocrinology Team assessed each patient and, when appropriate, prescribed cardioprotective medications to be continued at discharge. Upon discharge, all patients received a targeted intervention that included medication optimization, dietary counseling, and/or a scheduled post-hospital follow-up appointment to support continuity of diabetes care and adherence to AHA Stroke Honor Roll criteria. Compliance data from inception of the project (February 2025) through July 2025 were collected through the Get With The Guidelines®–Stroke registry and benchmarked against state of Illinois (IL) and national hospital performance. Results: The sample included 278 patients from UIH, with comparative data from hospitals across Illinois (IL, n = 10,987) and nationally (n = 88,484). At UIH, the proportion of patients aged >65 was 43.9%, which was lower than both the IL average (63.6%) and the national average (60.0%). A higher proportion of patients at UIH self-identified as Black (56%) compared to Illinois (23%) and national (21%) populations. The most common comorbidities observed were hypertension (73.3%), dyslipidemia (48.7%), diabetes (34.1%), atrial fibrillation (14.7%), and heart failure (10.8%). From February to July 2025, the SGLT2i and GLP1R agonists compliance rate at UIH increased significantly—from 28.6% to 66.7%. In contrast, compliance rates remained largely unchanged in IL (from 29.9% to 24.8%) and showed a modest increase nationwide (from 28.8% to 31.4%). Conclusion: Our multidisciplinary team-based intervention, led by the Endocrinology Team, significantly improved the use of SGLT2i and GLP1R agonists in patients with T2D admitted with acute ischemic stroke at UIH. Next steps include identifying patterns among non-compliant cases to further optimize adherence and patient outcomes.