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Is insulin an endogenous cardioprotector?
1EFA Sciences LLC, Norwood, Massachusetts, USA. undurti@hotmail.com
Insights
Maintaining normal blood glucose levels (euglycemia) is critical for patients with myocardial infarction. This approach helps reduce heart damage and improve recovery by managing hyperglycemia and its inflammatory effects.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- Stress hyperglycemia and diabetes mellitus in myocardial infarction (MI) patients elevate risks of mortality, heart failure, and shock.
- Hyperglycemia promotes inflammation by increasing free radical and decreasing nitric oxide generation.
- Insulin offers protective effects by reducing inflammation and improving myocardial function.
Purpose of the Study:
- To investigate the critical role of glucose-insulin balance in patient recovery after acute myocardial infarction.
- To highlight the benefits of maintaining euglycemia in critically ill patients.
Main Methods:
- Review of existing literature on hyperglycemia, insulin, and myocardial infarction outcomes.
- Analysis of the pathophysiological mechanisms linking glucose metabolism to cardiac function and inflammation.
Main Results:
- Euglycemia (plasma glucose ≤ 110 mg/dl) is associated with reduced infarct size and improved cardiac function.
- Insulin therapy demonstrates anti-inflammatory properties and enhances endothelial nitric oxide production.
- Imbalances in glucose and insulin levels negatively impact recovery and increase complication risks.
Conclusions:
- Maintaining euglycemia is crucial for improving outcomes in acute myocardial infarction patients.
- Glucose-insulin-potassium (GIK) cocktails may be beneficial in managing hyperglycemia and improving cardiac function.
- Attention to glucose control is essential for reducing mortality and morbidity in critically ill cardiac patients.
Abstract:
Stress hyperglycemia and diabetes mellitus with myocardial infarction are associated with increased risk for in-hospital mortality, congestive heart failure, or cardiogenic shock. Hyperglycemia triggers free radical generation and suppresses endothelial nitric oxide generation, and thus initiates and perpetuates inflammation. Conversely, insulin suppresses production of tumor necrosis factor-alpha and free radicals, enhances endothelial nitric oxide generation, and improves myocardial function. It is proposed that the balance between insulin and plasma glucose levels is critical to recovery and/or complications that occur following acute myocardial infarction and in the critically ill. Adequate attention should be given to maintaining euglycemia (plasma glucose