Evaluated the use of long-term insulin for better glucose control in diabetics presenting with acute coronary syndromes. All patients received insulin infusion then were randomized to a long-term insulin regimen or standard therapy. There was no evidence that long-term insulin improves survival or re-infarction compared to standard therapy. Glucose levels were determined to be a strong predictor of long-term mortality.
Eur Heart J. 2005 Apr;26(7):650-61. Epub 2005 Feb 23.
Eponym: Diabetes and Insulin-Glucose infusion in Acute Myocardial Infarction 2 Trail
Purpose: To evalute strict glucose control in patient with acute coronary syndromes and confirm the findings of the DIGAMI Trial.
Format: Doubleblind, multicenter, randomized control trial
Treatment Group: Insulin IV infusion (insulin drip) then either insulin OR standard treatment
Control Group: Routine diabetes management
Number of Patients: 1,253
Diabetes Mellitus Type II
Admission glucose level > 11 mmol/L
Suspected acute coronary syndrome
Inability to cope with insulin treatment
Follow-up: Mean of 2.1 years
Primary Endpoint: All-cause mortality between the longer term insulin versus the standard treatment
Secondary Endpoint: All-cause mortality between the early insulin only (not long term) versus the standard treatment
Review of Unstable Angina and Non-ST Segement Elevation Myocardial Infarction
Review of ST Elevation Myocardial Infarction