Effect of hyperglycemia and insulin in acute coronary syndromes.
Previously published data clearly demonstrate that hyperglycemia worsens morbidity and mortality in patients in intensive care, those with acute myocardial infarction and stroke, and those undergoing coronary artery bypass grafting. The control of hyperglycemia with insulin infusion improves clinical outcomes in these patients. In this article, we discuss data that demonstrate a proinflammatory effect of glucose and free fatty acids and an anti-inflammatory effect of insulin. We also provide a mechanistic justification for the benefits of maintaining euglycemia with insulin infusion in hospitalized patients.
Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo, Buffalo, New York, USA. pdandona@kaleidahealth.org
Paresh
P
Dandona
Ajay
A
Chaudhuri
Husam
H
Ghanim
Priya
P
Mohanty
D001786:Blood Glucose; D002986:Clinical Trials as Topic; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000517:prevention & control*
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin