Objective. Systemic thrombolytic therapy (STLT) is an available method of treatment of ischemic stroke (II) with proven efficacy. The efficacy and safety of STLT in certain groups of patients, in particular with diabetes mellitus type 2 (T2DM), are being discussed. To compare the efficacy and safety of STLC in II patients with T2DM, hyperglycemia and normoglycemia. Material and methods. Eighty-six patients were examined, including 23 with T2DM (7 newly diagnosed), 27 with hyperglycemia at stroke onset and 36 with normoglycemia. Cardioembolic subtype of II was diagnosed in 35%, atherothrombotic in 29%, lacunar in 7%. In other patients, the subtype was unknown. STLT was administered to all patients 153.8±4.7 min after stroke onset. Results. At admission, the NIHSS severity of II and the level disability assessed by the Rankin scale did not differ in the three groups. A significantly lower regression was observed in patients with T2DM (p<0.01) in the 28th day. The fatality was higher in this group compared to the patients with normoglycemia (p<0.05). The frequency of symptomatic hemorrhagic transformation (SHT) was higher (56.5%) as well. After treatment, status of surviving patients in all groups has improved to the end of hospitalization, which was reflected in a significant decrease in NIHSS compared to baseline (p<0.01). Conclusion: The data indicate an increased risk of SGT after STLC in patients with T2DM. Significant positive changes in the surviving patients with T2DM confirm the feasibility of STLC in patients with T2DM.