[Does diabetes affect the choice of pharmaceutical treatment in coronary artery disease?]

Coronary artery disease is the principal cause of death in diabetic patients. The choice of pharmaceutical treatment used in diabetic patients with coronary artery disease should be based on that of non-diabetic coronary patients (BASIC). However, diabetes has its own specificities. First of all, dietetic measures and physical exercise should be continually encouraged. The questions about the basic treatment concern mainly the choice of oral platelet antiaggregants and the need to associate these drugs systematically and definitively. With regards to the management of acute coronary syndromes, the important point is the improved short and long-term benefits of GP IIb/IIIa on the survival of diabetic coronary patients, especially when angioplasty is performed. Finally, intravenous insulin therapy is promising in the initial phase of treatment of acute coronary syndromes with better defined blood glucose objectives.