Abstract Body: Introduction:
Diabetes Mellitus (DM) is a significant risk factor for acute ischemic stroke (AIS) and the incidence of newly diagnosed DM in AIS is higher in certain ethnicities. We aim to examine prescribing patterns of anti-hyperglycemic medications (anti-DM) in hospitalized AIS patients with newly diagnosed with DM. We also examine ethnic disparities in prescribing patterns amongst Hispanic and Non-Hispanic patients.

Methods:
We retrospectively examined prospectively collected data from an IRB-approved stroke registry at two academic Comprehensive Stroke Centers (CSCs). We included patients with a new diagnosis of AIS with no documented history of DM between 1/1/2013 and 6/30/2024. We examined baseline demographics, comorbidities, ethnicity, insurance status, acute stroke treatment, NIHSS, A1c, blood glucose and their association with anti-DM prescribing patterns. We also evaluated prescribing differences in Hispanic versus Non-Hispanic groups. Data was analyzed using correlation matrix, Pearson’s and Spearman’s correlation coefficients, and Chi-squared and t test, as appropriate.

Results:
A total of 2870 AIS patients were identified in the study period. Of these, 20.1% (n=578) were Hispanic, 42.5% (n=1219) were female, and 47.8% (n=1373) had Medicare as their payment source. New diagnosis of DM occurred in 6.0% (n=52/863), and 52.0% (n=27) were prescribed anti-DM at discharge. Overall, only a history of previous stroke was independently associated with prescribing anti-DM on discharge (p=0.03). Of patients with new DM, Hgb A1c (p=0.01) and blood glucose (p=0.006) were significantly associated with prescribing anti-DM on discharge. Patients with Medicaid (p=0.04) and no previous medical history (p=0.02) were less likely to receive anti-DM. Mean Hgb A1c was higher in patients that were prescribed anti-DM vs not prescribed anti-DM (8.82 vs. 7.13; p=0.007, 95% CI: -2.87 to -0.52). There was no difference in prescribing anti-DM in Hispanic vs. Non-Hispanic groups.

Conclusions:
In this study at two academic CSCs, there was no significant difference in prescribing anti-DM medications in Hispanic vs. Non-Hispanic groups, but insurance status may be associated with prescribing patterns. The provision of systematic care helped reduce healthcare disparity in AIS patients with newly diagnosed DM.