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Prevalence and management of hyperglycaemia in patients given thrombolysis for acute coronary syndromes

Beta Cell Diabetes Centre, Chelsea & Westminster Hospital, London, SW10 9NH, UK, kevin.baynes{at}gstt.sthames.nhs.uk

Colin Mcintosh

Beta Cell Diabetes Centre, Chelsea & Westminster Hospital, London, SW10 9NH, UK

Michael D Feher

Beta Cell Diabetes Centre, Chelsea & Westminster Hospital, London, SW10 9NH, UK

The prevalence of hyperglycaemia in patients given thrombolysis for suspected acute myocardial infarction has not been clearly established. This is a retrospective case-note study of 69 consecutive patients who received thrombolysis on admission to a coronary care unit over a 15-month period. Admission plasma glucose > 7.8 mmol/L was observed in 46%, whilst a random glucose > 11.0 mmol/L was recorded in 22% of the group. A history of type 2 diabetes was present in 19%; with a glucose > 11.0 mmol/L being recorded in 61% on admission. Intravenous insulin therapy was administered to 43% of those without a history of diabetes, but presentation hyperglycaemia in the diabetic range, whereas 88% of known diabetic patients were treated with insulin.

Hyperglycaemia/glucose intolerance, although commonly observed in patients thrombolysed for acute myocardial infarction, is not always managed with insulin therapy. There is a need for clear diabetes management protocols for all teams managing patients in coronary care units.

Key Words: acute coronary syndrome • diabetes mellitus • insulin therapy.

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The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 5, 346-348 (2003)
DOI: 10.1177/14746514030030050601


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