[Cardiovascular risk in diabetes--diagnostic and therapeutic aspects]

Abstract

In Germany, more than 27,000 diabetic patients suffer an acute myocardial infarction annually; in addition, the number of cardiac infarction patients with unrecognized permanent disturbances of the glucose metabolism is high. The cardiovascular mortality of diabetics in comparison with nondiabetics is four to six times higher. Through an intensification of diagnostics and therapy, it is possible to reduce the hospital mortality of diabetics with acute myocardial infarction. For each patient with myocardial infarction and for whom diabetes has not been previously diagnosed, it is recommended that the blood sugar be tested upon admission to the hospital and that an oral glucose tolerance test be conducted for the detection of a glucose metabolic disorder during the postinfarction phase. An example of a successful approach for metabolic intervention is glucose-insulin infusion to optimize the metabolic condition during the acute phase.