Glycemic Control and Acute Coronary Syndrome on CV Outcome among Type 2 Diabetic patients

Abstract

Acute coronary syndrome (ACS) is significantly more common and deadly in diabetes people compared to nondiabetic patients. Despite the abundance of research on the relationship between glycemic control and cardiovascular risk, there is a dearth of literature on the topic of strict glycemic control in the context of acute coronary syndromes (ACS). That is why we provided a critical analysis of the research that looked into this particular subject in this review. There are various biochemical pathways that link hyperglycemia to vascular injury and cardiac myocyte mortality. These pathways include advanced glycation end products, protein kinase C, the polyol pathway flow, and the hexosamine route. In addition, endothelial dysfunction can result from elevated FFA concentrations, which might be harmful to acute ischemic myocardium through many routes. A glucose-insulin-potassium infusion (GIKi) can be administered during AMI to decrease plasma levels of free fatty acids and enhance glucose availability. Both the long-term prognosis and the mechanical performance of the left ventricle are improved when the GIKi is used. The significance of glucose control in the care of diabetic patients with recent ACS was highlighted by the DIGAMI investigations, which indicated that blood glucose level was a substantial and independent predictor of mortality in this population. Scientific society position statements and other procedures endorsing strict glycemic control during ACS were emphasized.