Diabetes care
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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 less than 234 mg/dl; 13 mmol/L) was achieved in only 60%. ⋯ Control was adequate in 87% (P less than 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 less than 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.