- Paper Report
- Open Access
Diabetes and insulin use on AMI survival - is enough being done?
- Joanna Lyford1
© Biomed Central Ltd 2001
- Received: 7 March 2001
- Published: 18 October 2001
- Acute myocardial infarction, diabetes, insulin, mortality
Diabetes is highly prevalent among elderly patients with acute myocardial infarction (AMI). This study investigates the role of diabetes in the mortality of patients with AMI.
The mean age of the groups lay between 75 and 78 years. Patients with diabetes had higher incidences of hypertension and prior AMI, congestive heart failure, and revascularization, especially those on insulin. Diabetics were less likely to receive aspirin, ? blockers, or undergo coronary revascularization; again, this was especially the case for those on insulin. Non-diabetic patients had the lowest mortality at both 30 days (20.3%) and one year (33.8%). Diet-controlled diabetic patients had the highest mortality at 30 days (24.3%), but insulin-treated patients had the highest mortality at one year (43.5%). Diabetic patients treated with an oral hypoglycemic agent had lower 30-day and 1-year mortality than diabetic patients treated with diet alone or with insulin.
Data from a retrospective cohort study of patients hospitalized with AMI were used to evaluate the role of diabetes in 30-day and 1-year mortality. Patients were classified as non-diabetics (80,832 patients), diet-controlled diabetics (9862), diabetics receiving an oral hypoglycemic agent (14,664), and diabetics on insulin therapy at time of admission (12,241).