DIGAMI 2 Trial

Trial Details:

Acronym: Diabetes and Insulin-Glucose infusion in Acute Myocardial Infarction 2 Trial

Purpose: To evaluate strict glucose control in patient with acute coronary syndromes and confirm the findings of the DIGAMI Trial.

Format: Doubleblind, multicenter, randomized control trial

Treatment Group: Insulin IV infusion (insulin drip) then either insulin OR standard treatment 

Control Group: Routine diabetes management

Number of Patients: 1,253

Inclusion Criteria:

• Diabetes Mellitus Type II
• Admission glucose level > 11 mmol/L
• Suspected acute coronary syndrome

Exclusion Criteria:

• Inability to cope with insulin treatment

Follow-up: Mean of 2.1 years

Primary Endpoint: All-cause mortality between the longer term insulin versus the standard treatment

Secondary Endpoint: All-cause mortality between the early insulin only (not long term) versus the standard treatment

Summary:

Evaluated the use of long-term insulin for better glucose control in diabetics presenting with acute coronary syndromes. All patients received insulin infusion then were randomized to a long-term insulin regimen or standard therapy. There was no evidence that long-term insulin improves survival or re-infarction compared to standard therapy. Glucose levels were determined to be a strong predictor of long-term mortality.

Original Publication:

Malmberg K, et al. Eur Heart J. 2005;doi:10.1093/eurheartj/ehi199.