A randomised study of insulin/dextrose infusion for myocardial infarction in patients with diabetes. [ 2001 - 2003 ]

Research Grant

Researchers: Prof Ngai Cheung (Principal investigator) ,  Dr Kris Park ,  Prof Mark Mclean

Brief description In Australia, some 5-10% of the population have diabetes, and the prevalence is rising. Some 50% of diabetics over the age of 40 will die from cardiovascular disease, and the cardiac mortality amongst patients with diabetes is 3 times that of the general population. One quarter of patients admitted to hospital in Australia with myocardial infarction (heart attack) have diabetes. Myocardial infarction (AMI) is much more likely to be fatal for a person with diabetes, and the mortality rate after one year is about double that of the non-diabetic population. Whilst considerable advances have been made in recent years in reducing the mortality from AMI, there have been few studies with the specific aim of optimising management for patients with diabetes in this situation. One recent study (the DIGAMI Study) however, examined the use of insulin-dextrose infusion therapy at the time of AMI for patients with diabetes and found a significant reduction in mortality rate amongst treated patients. However, due to the design of the study, it is not possible to determine if it was the insulin-dextrose infusion which resulted in the reduced mortality, or if it was one of a number of confounding variables. Nonetheless, the DIGAMI Study has raised the possibility that insulin-dextrose infusion will improve the outcome for diabetics, and theoretically, there are good reasons that this may provide a real benefit, via a reduction in free fatty acids, which may potentiate damage to the heart. Our study aims to determine if insulin-dextrose infusion therapy improves the prognosis of diabetic subjects with AMI. This will be performed as a randomised controlled trial across 4 teaching hospitals. If its benefit are confirmed, then this will have significant implications for the management of diabetics with AMI, as insulin-dextrose infusions are not currently routine, especially for patients with lower levels of hyperglycaemia.

Funding Amount $AUD 181,018.36

Funding Scheme NHMRC Project Grants

Notes New Investigator Grant