A one-year retrospective audit of the DIGAMI protocol

Abstract

Aim To assess the impact of post-MI diabetes-care upon changes in diabetes therapy and on cardiovascular risk factors.

Patients and methods Retrospective audit of case notes of patients with diabetes who were treated according to the DIGAMI protocol following an acute MI and who had completed at least one year of follow-up (n=86).

Results A majority of patients continued insulin therapy beyond the standard recommendation of three months (7%, 84%, 75% at 0, 3 and 12 months respectively) resulting in an increase in the number of patients attending hospital diabetes clinics (17%, 94% and 61%). A majority of patients belonged to DIGAMI low-risk group 1 (85%) which was the category of patients shown to have a significant survival benefit in the original DIGAMI cohort. At the end of one year an increased number of patients achieved targets for control of systolic BP (49, 59 and 77 at 0, 3 and 12 months), diastolic BP (44, 74 and 77%), TC (34, 73 and 80%) and HbA₁C (24, 45 and 60%) (p<0.05 for all). Weight increased progressively (82 kg, 87 kg A and 88 kg, p<0.05). Percentage of smokers was reduced (31, 9 and 11, p<0.05).

Conclusion There was a significant rise in the number of patients receiving long-term insulin therapy, and attending secondary care follow-up. A significant and sustained increase was observed in achieving targets for HbA_1C, BP and cholesterol.