Insulin treatment after a heart attack
High blood glucose levels along with high blood pressure, high cholesterol levels (blood fats) and cigarette smoking can narrow and harden vessels in the heart, which can lead to a heart attack.
A research study performed in 1997 DIGAMI (The Diabetes Mellitus Insulin Glucose Infusion In Acute Myocardial Infarction) has shown that people with diabetes who transfer to insulin therapy after a heart attack live longer than those who remain on diet or tablets.
Therefore all people with diabetes who are admitted to the University Hospitals of Leicester following a heart attack will be treated with a glucose/insulin drip into a vein in the arm (IV) for 24 hours.
The following recommendations exist for managing diabetes in people who has suffered a heart attack;
- Patients with type 1 or type 2 who are insulin treated 24 hours, IV insulin then; their normal insulin and doses are recommenced once the drip has finished (If the long-term control of diabetes is poor, a review of their insulin and doses may be needed).
- In people with type 2 diabetes treated with tablets, the tablets will be stopped and insulin injections will be started after the drip has finished.
- In people who previously did not have diabetes until found on hospital admission, the drip is stopped and blood glucose levels are measured for 48 hours. If these levels are raised on one or more occasions, insulin injections will be started.
The current evidence suggests that long-term insulin may be of benefit therefore we recommend that insulin is usually continued for life. However all patients will be reviewed after 3 months to discuss insulin therapy.