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Crit Care. 2002 Oct;6(5):389-93. Epub 2002 Jul 31.

Is insulin an endogenous cardioprotector?

Author information

1
EFA Sciences LLC, Norwood, Massachusetts, USA. undurti@hotmail.com

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 <or= 110 mg/dl) in order to reduce infarct size and improve cardiac function while using a glucose-insulin-potassium cocktail.

PMID:
12398773
PMCID:
PMC137317
DOI:
10.1186/cc1535
[Indexed for MEDLINE]
Free PMC Article

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