Blood glucose control in patients with diabetes after myocardial infarction is often poor, and this may contribute to increased mortality in the diabetic patient. A retrospective review of the records of 71 diabetic patients admitted with suspected myocardial infarction, and managed using a variety of methods, showed that adequate control (mean blood glucose <234 mg/dl; 13 mmol/L) was achieved in only 60%. Continuation of oral hypoglycemic agents and the use of irregular intermittent insulin in response to hyperglycemia were particularly associated with poor control. In a prospective study 68 consecutive patients were managed using regular subcutaneous insulin injections three times daily or a glucose-insulin-potassium intravenous infusion (in those with cardiogenic shock, severe hyperglycemia, or unable to eat). Control was adequate in 87% (P < 0.001 versus retrospective group) and mean blood glucose concentration on days 1 and 2 were significantly lower than in the retrospective group (167 versus 232; 165 versus 236 mg/dl; both P < 0.001). Simple protocols using three-times-daily subcutaneous insulin or glucose-insulin-potassium infusion provide a practical method for achieving good glycemic control in the diabetic patient with suspected acute myocardial infarction.
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Original Articles| May 01 1985
Methods for the Control of Diabetes After Acute Myocardial Infarction
D J Husband, B.Sc, M.R.C.P.;
K G M M Alberti, D.Phil, F.R.C.P.;
Address reprint requests to Dr. D. J. Husband, Department of Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, England.
Diabetes Care 1985;8(3):261–267
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D J Husband, K G M M Alberti, D G Julian; Methods for the Control of Diabetes After Acute Myocardial Infarction. Diabetes Care 1 May 1985; 8 (3): 261–267. https://doi.org/10.2337/diacare.8.3.261
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