04 May 2005

Heart Attack Among Diabetics

If you or someone you know is a Type 2 diabetic, this is an important news for you.

A new study says that strict blood sugar control is the critical factor among diabetics who suffer from heart attacks or acute myocardial infarction episodes.

Diabetes Control Crucial After Heart Attack

NEW YORK --- For people with type 2 diabetes who suffer a heart attack, keeping their blood sugar levels under control has a lot to do with how well they fare, according to a multicenter European study.

However, intensive insulin therapy does not seem to be necessary to achieve the best outcomes. "Insulin does not seem to be the only solution, but tight glucose control by any means is very important." Dr. Lars Ryden from the Karolinska Institute, Stockholm, told Reuters Health.

Ryden advises doctors to "use all available tools to keep blood glucose...down."

[Reuters Health]

The full text of the study, published in the April 2005 issue of the European Heart Journal can be read here.

This finding comes from DIGAMI 2 or the second Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction Study done in Europe. And if there's DIGAMI 2, there must be DIGAMI 1.

In DIGAMI 1, it was shown that the use of a glucose/insulin infusion among diabetic patients who recently had heart attacks decreased mortality rates by 30 to 50 percent. Also, A1c or glycosylated hemoglobin values among patients receiving the glucose/insulin infusion were shown to have decreased by as much as 1.5 percent. That percentage might be miniscule for you, but for doctors, that kind of result is more than enough to make us happy.

Because DIGAMI 1's results were too good to be true, researchers had to go and make DIGAMI 2. They wanted to test how valid DIGAMI 1's results were.

DIGAMI 2 had a similar trial design as DIGAMI 1, but this time there was an intervention stratification --- there were 3 glucose-control strategies --- 2 insulin-based and 1 based on standard practice.

The results?

Well, this time, the researchers only saw minor differences in long-term A1c values between the 3 groups. The researchers found that, contrary to DIGAMI 1's results, it is NOT TRUE "that an acutely introduced, long-term insulin treatment improves survival in type 2 diabetic patients following myocardial infarction."

But what the researchers agreed after an epidemiologic analysis was that "the glucose level is a strong, independent predictor of long-term mortality" and that "glucose control seems to be an important part" of the patient management. I say, IT IS THE MOST IMPORTANT!

My opinion is that if you are a diabetic, you need not wait for a heart attack to control your blood sugar levels.

Do it now. Control your blood sugar levels NOW.

You know the drill: DIET and EXERCISE. Do these two alone religiously, and (I bet you) you won't need too much anti-diabetic medication.

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