Abstract
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.
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