Problem DM in acute MI
Format Double-blinded multi-center RCT
Treatment Insulin infusion, later SC insulin
Control Routine DM therapy
Population 620
Inclusion criteria Inclusion criteria were suspected acute myocardial infarction within the preceding 24 h combined with previously known diabetes mellitus and a blood glucose level >11 mmol/liter or a blood glucose level >11 mmol/liter even without known diabetes mellitus
Exclusion criteria The following exclusion criteria were applied: inability to participate for reason of health (e.g., too sick to give informed consent or unable to manage multidose insulin treatment), refusal to participate, residence outside the hospital catchment area, enrollment in other studies and previous participation in DIGAMI.
Follow-up Average 3.4 years
Primary endpoint All cause mortality
Secondary endpoint(s) -
Details Before randomization, the patients were stratified into 4 groups on the basis of risk classification and previous use of insulin. High-risk patients fulfilled ≥2 of the following criteria: age >70 years, history of previous AMI, history of congestive heart failure, or ongoing treatment with digitalis. The predefined strata were (1) no insulin and low risk, (2) no insulin and high risk, (3) insulin and low risk, and (4) insulin and high risk.
Brief summary: Insulin sliding scale improved post-MI mortality in diabetics
PAPER: Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: long-term results from the Diabetes...
Date 25 May 1999
Journal Circulation. 1999 May 25;99(20):2626-32.
Information Insulin treatment associated with improved
-Long-term mortality
-Blood glucose level
-Thrombolysis efficiency