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European Heart Journal Advance Access originally published online on May 24, 2005
European Heart Journal 2005 26(13):1245-1248; doi:10.1093/eurheartj/ehi302
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

The difficult task of glycaemic control in diabetics with acute coronary syndromes: finding the way to normoglycaemia avoiding both hyper- and hypoglycaemia

Antonio Abbate1,* and Giuseppe G.L. Biondi-Zoccai2

1Department of Internal Medicine, Virginia Commonwealth University, 10025 Bellona Court, Richmond, VA 23233, USA
2Interventional Cardiology Unit, St Raffaele University Hospital, Milan, Italy

* Corresponding author. Fax: +1 360 323 1204. E-mail address: abbatea@yahoo.com

This editorial refers to ‘Association between hyper- and hypoglycaemia and 2 year all-cause mortality risk in diabetic patients with acute coronary events’{dagger} by A.M. Svensson et al., on page 1255

The first 150 words of the full text of this article appear below.

Considering glycaemic control in diabetes, we often think that all metabolic syndromes are born equal and, as for cholesterolaemia, ‘the less the better’. Perhaps not in diabetes. Diabetes mellitus is a metabolic syndrome characterized by absolute or relative insulin deficiency. Despite the simplicity of the concept of insulin deficiency and hyperglycaemia, the mechanisms underlying the variable complications of diabetes are often unclear.

Diabetics are a high cardiovascular risk population at increased risk of new or recurrent episodes of atherothrombosis, and these patients with acute coronary syndromes have the worse outcome when compared with non-diabetics, independently from the therapeutic approach.1 Furthermore, even new onset stress hyperglycaemia in patients with acute myocardial infarction (AMI) predicts adverse outcome.2,3 Nevertheless how much and how anti-diabetic treatment affects survival in patient with AMI is still unclear. Svensson et al.4 report the prognostic value of admission and in-hospital glycaemic values in patients admitted with AMI. The authors . . . [Full Text of this Article]

Hyperglycaemia and adverse outcome: overwhelming evidence

Hyperglycaemia and myocardial metabolism

Hyperglycaemia and inflammation

Hyperglycaemia and apoptosis

Hypoglycaemia and adverse prognosis: bad news

Hypoglycaemia, adrenergic and metabolic derangements, and myocardial ischaemia

Hypoglycaemia and long-term outcome

Glycaemic control: where do we go from here?

Acknowledgements


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Related articles in EHJ:

Association between hyper- and hypoglycaemia and 2 year all-cause mortality risk in diabetic patients with acute coronary events
Ann-Marie Svensson, Darren K. McGuire, Putte Abrahamsson, and Mikael Dellborg
EHJ 2005 26: 1255-1261. [Abstract] [Full Text]