Glycemic Control for Patients With Acute Myocardial Infarction

The risk of myocardial infarction increases in patients with diabetes mellitus.The incidence of myocardial infarction is similar in patients with type 2 diabetes without history of myocardial infarction and in non-diabetic patients with history of myocardial infarction.Diabetes mellitus was considered as a coronary disease equivalent by the National Cholesterol Education Program.Strict glycemic control can improve the long-term outcome of both type 1 and type 2 diabetes mellitus.Whatever with diabetic or non-diabetic,strict glycemic control with intensive insulin therapy can reduce the mortality of critically ill patients in hospital.After myocardial infarction,there would be a worse outcome for patients with poor glycemic control,whatever in diabetic or non-diabetic patients with stress hyperglycemia.Meanwhile,strict glycemic control can improve the outcome.The guideline of American College of Cardiology/American Heart Association in 2004 on ST-elevated myocardial infarction recommended insulin infusion maintaining the euglycemia for patients with acute myocardial infarction and complicated conditions,whether with diabetes mellitus or not,and it was considered reasonable to infuse insulin for all patients with hyperglycemia during the period of acute myocardial infarction.This paper proposed an effective and safe method for intravenous insulin infusion therapy for diabetic patients with acute myocardial infarction.