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Updated: Apr 17, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Refractory hyperglycaemia induced by glucose-insulin-potassium infusion in acute myocardial infarction
Background:
Recent randomised clinical trials have not confirmed the beneficial effects of glucose-insulin-potassium (GIK) infusion observed in experimental models of myocardial ischaemia and infarction.
Methods:
We investigated glucose levels and insulin dose in 107 patients treated with reperfusion therapy and GIK for acute myocardial infarction.
Results:
Despite high insulin infusion rates, persistent hyperglycaemia occurred in 37% of the patients. These patients had significantly larger infarctions, as measured by enzyme release (p=0.006). In a multivariate model predicting high troponin levels, refractory hyperglycaemia remained a significant parameter (p=0.02).
Conclusion:
These findings suggest that refractory hyperglycaemia caused by high-dose glucose infusion may, at least in part, explain the discrepancy between the experimental and clinical data.
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