Diabetestherapie des akuten Koronarsyndroms

The early and differentiated optimization of the glucose level is essential for the improvement of cardiovascular disease. In all stages of such diseases, attaining a near-normal glucose range is the primary goal. The DIGAMI 1 and 2 studies as well as the Munich Myocardial Infarction Registry demonstrate that an intensification of treatment with insulin reduces mortality due to myocardial infarction. Giving insulin in the acute phase of cardiovascular complications is the therapy of choice to counter hyperglycemia quickly and over the long-term. Here, glucose-insulin infusion is advantageous as a controllable concept. In non-acute cardiac disease, insulin therapy and oral treatment strategies alone or in combination can be successful. Acarbose and metformin can successfully prevent cardiovascular disease. New evidence of the positive effects of glitazones in reducing the rate of restenosis and optimizing endothelial function is currently emerging.