Inpharma 1490 - 4 Jun 2005

Long-term insulin therapy does notimprove survival after MI

Among patients with type 2 diabetes mellitus, acutely-introduced, long-term insulin treatment does notimprove survival following myocardial infarction (MI)when compared with standard treatment, according toresults from the DIGAMI 2* study.

1253 patients with diabetes who experienced MIwere randomised to treatment with an IV insulin/glucose infusion for 24 hours followed by SC insulin-based long-term glucose control (group 1; n = 474), IVinsulin/glucose for 24 hours followed by standardinsulin control (group 2; 473), or routine metabolicmanagement (group 3).

There were no significant between-group differencesin the incidences of mortality, with estimated mortalityrates of 23.4%, 21.2% and 17.9% in groups 1, 2, and 3,respectively.

Significantly fewer patients in group 3 than ingroups 1 and 2 received an infusion of insulin/glucose.Although blood glucose levels were significantly lowerin groups 1 and 2 than group 3 after 24 hours, therewere no significant between-group differences in bloodglucose and glycosylated haemoglobin levels whenAUCs were compared.

The incidences of stroke and myocardial infarctionwere lower in groups 2 and 3 than in group 1, but thedifferences between the groups were not significant.* Diabetes Insulin-Glucose in Acute Myocardial Infarction

Malmberg K, et al. Intense metabolic control by means of insulin in patients withdiabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortalityand morbidity. European Heart Journal 26: 650-661, No. 7, Apr 2005 800992227

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Inpharma 4 Jun 2005 No. 14901173-8324/10/1490-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved