The role of insulin therapy and glucose normalisation in patients with acute coronary syndrome

Jonathan Lipton, Anil Can, Salima Akoudad, Maarten Simoons

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6 Citations (Scopus)
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Patients with acute myocardial infarction (AMI) and diabetes mellitus, as well as patients admitted with elevated blood glucose without known diabetes, have impaired outcome. Therefore intensive glucose-lowering therapy with insulin (IGL) has been proposed in diabetic or hyperglycaemic patients and has been shown to improve survival and reduce incidence of adverse events. The current manuscript provides an overview of randomised controlled trials investigating the effect of IGL. Furthermore, systematic glucose-insulin-potassium infusion (GIK) has been studied to improve outcome after AMI. In spite of positive findings in some early studies, GIK did not show any beneficial effects in recent clinical trials and thus this concept has been abandoned. While IGL targeted to achieve normoglycaemia improves outcome in patients with AMI, achievement of glucose regulation is difficult and carries the risk of hypoglycaemia. More research is needed to determine the optimal glucose target levels in AMI and to investigate whether computerised glucose protocols and continuous glucose sensors can improve safety and efficacy of IGL.
Original languageUndefined/Unknown
Pages (from-to)79-84
Number of pages6
JournalNetherlands Heart Journal
Issue number2
Publication statusPublished - 2011

Research programs

  • EMC COEUR-09

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