MANAGEMENT OF DIABETES IN ACUTE MYOCARDIAL INFARCTION IN CELJE GENERAL HOSPITAL IN 1999
Abstract
Background. DIGAMI study showed that intrahospital mortality and mortality at one year after myocardial infarction can be significantly reduced in diabetics treated in acute phase of myocardial infarction by GI infusion and afterwards for at least three months with intensive insulin treatment. Mortality can be reduced for more than 50% in a subgroup of patients younger than 70 years, without congestive heart failure, with first myocardial infarction, not treated with insulin or digitalis. In this perspective we reviewed treatment of diabetics with acute myocardial infarction in 1999 in Celje General Hospital.
Methods. We reviewed documentation of treatment of all diabetics with acute myocardial infarction treated in Celje General Hospital in 1999. We collected data on number of newly discovered diabetes, on previous treatment of diabetes, on treatment of diabetes during hospitalization and at discharge, on drugs used for treatment of diabetes and on mortality during hospitalization.
Results. Diabetics presented 20% of all patients with acute myocardial infarction treated in Celje General Hospital in 1999. None of patients received GI infusion, none had intensively managed blood sugar. 24% of patients were treated with sulfonylureas in acute phase of myocardial infarction. 33% of patients were discharged from hospital with insulin therapy. Intrahospital mortality was 9%, comparable with patients without diabetes.
Conclusions. In 1999 was intrahospital treatment of diabetics with acute myocardial infarction in Celje General Hospital successful as their intrahospital mortality equaled non-diabetics. Treatment of diabetes itself, during hospitalization and after discharge, on the other hand, in 1999 had not been up to date according to results of recent studies. In our opinion, it is mandatory for diabetologist to make part of the team that treats diabetic with acute myocardial infarction
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References
Karlson BW, Herlitz J, Hjalmarson A. Prognosis of acute myocardial infarction in diabetic and non-diabetic patients. Diabet Med 1993; 10: 449–54.
Abbud ZA, Shindler DM, Wilson AC et al. Effect of diabetes mellitus on shortand long-term mortality rates of patients with acute myocardial infarction: A statewide study. Am Heart J 1995; 130: 51–8.
Behar S, Boyko V, Reicher-Reis H et al. Ten-year survival after acute myocardial infarction: Comparison of patients with and without diabetes. Am Heart J 1997; 133: 290–6.
Klamman A, Sarfert P, Launhardt V et al. Myocardial infarction in diabetic vs. non-diabetic subjects; survival and infarct size following therapy with sulfonylureas (glibenclamide). Eur Heart J 2000; 21: 220–9.
Zuanetti G, Latini R, Maggioni AP et al. Influence of diabetes on mortality in acute myocardial infarction: data from the GISSI-2 study. J Am Coll Cardiol 1993; 22: 1788–94.
Malmberg K, Rydén L, Efendic S et al. A randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction: Effect on one year mortality. J Am Coll Cardiol 1995; 26: 57–65.
Fisher BM. Diabetes and myocardial infarction: critical evaluation of the DIGAMI study. Practical Diabetes International, 1998; 101–2.
Garratt KN, Brady PA, Hassinger NL et al. Sulfonylurea drugs increase early mortality in patients with diabetes mellitus after direct angioplasty for acute myocardial infarction. J Am Coll Cardiol 1999; 33: 119–24.
UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53.
Tenerz A, Lönnberg I, Berne C, Nilsson G, Leppert J. Myocardial infarction and prevalence of diabetes mellitus. Is increased causual blood glucose at addmission a reliable criterion for the diagnosis of diabetes? Eur Heart J 2001; 22: 1102–10.
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