Type 2 diabetes mellitus and coronary heart disease

Coronary artery disease is the most common cause of morbidity and mortality in subjects with type 2 diabetes mellitus. The risk of coronary artery dis ease, myocardial infarction and mortality from myocardial infarction is mar kedly increased in type 2 diabetic patients compared with non-diabetics. Diabetic patients with acute myocardial infarction should receive thromboly tic therapy as rapidly as possible and for the same indications as non-diab etics. Diabetic retinopathy is not a contraindication to treatment. The man agement of diabetic patients should also include medication with aspirin, b eta-blockers and ACE-inhibitors. An insulin-glucose infusion during acute m yocardial infarction, followed by insulin injections subcutaneously, reduce s mortality by about 30% after 12 months and improves long-term prognosis. Thus, insulin-glucose infusion in diabetic patients with acute myocardial i nfarction, especially in those with a high blood glucose level (>11 mmol/l) , seems advisable. Diabetic patients benefit from secondary prevention by drug therapy (aspiri n, lipid lowering with statins, beta-blockers and ACE-inhibitors) to the sa me extent as, or more than, non-diabetic patients.