Metabolic control in diabetic subjects following myocardial infarction: difficulties in improving blood glucose levels by intravenous insulin infusion.
Optimal metabolic control during the first twelve hours after myocardial infarction may be associated with improved survival in diabetic subjects. A comparison of an intravenous insulin infusion regimen aimed at improving blood glucose levels (n = 35), with 'routine control' (n = 34) in the post infarction period has been carried out in diabetic subjects admitted to four Coronary Care Units over a two year period. However, glycaemic control was similar in both groups (intravenous infusion regimen, mean +/- SD capillary blood glucose 10.3 +/- 2.1 mmol/l, 'routine control' glucose 10.7 +/- 3.6 mmol/l). There were no differences in the rates of arrhythmias (31% v 32%), heart failure (46% v 47%) or mortality (17% v 18%). Mortality in diabetic subjects was lower than that quoted in previous studies but was higher than in non-diabetic subjects admitted to the Coronary Care Unit during the same period. Attempts to improve glycaemic control by means of intravenous insulin infusion were unsuccessful.
Davies
R R
RR
Ninewells Hospital and Medical School, Dundee.
Newton
R W
RW
McNeill
G P
GP
Fisher
B M
BM
Kesson
C M
CM
Pearson
D
D
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001786:Blood Glucose / Q000378:metabolism*; D003325:Coronary Care Units; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011446:Prospective Studies
D001786:Blood Glucose; D007328:Insulin