1
PERSONAL COMMENT Diabetes and myocardial infarction:do we have time to wait? 3. Frier BM. Diabetes and myocardial infarction. Diabetes Rev Inf 1998; 7(2): 1-2 4. Davey G,McKeigueP. Insulin infusionin diabetic patients with acute myocardial infarction. BMJ 1996; 31363940 5. Nattrass M. Managing diabetes after myocardial infarction.BMJ 1997; 314: 1497 6. Gerstein HC. Insulin infusion followed by mul- tipledaily insulin injectionsreducedmortality afterMIin diabetes. ACP Journal Club 1996; 124: 1 7. Yudkin JS. Intensive insulin regimen reduced long-term mortality after MI in diabetes mellitus. ACP Journal Club 1997; 127:60 8. Sackett DL. How to practice and teach evidence- based medicine. Educational scenarios for teaching EBMinprimarycare.Oxford,UK, 1997,p154,p202 9. Malmberg KA, Efendic S, Ryden LE. Feasibility of insulin-glucose infusionin diabeticpatients with acute myocardial infarction. Diabetes Care 1994;17: 1007-14 10. Malmberg K, Ryden L, Efendic S, et al. Ran- domised trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAM1 Study): Effects onmortalityat 1 year. JAm CollCurdiol1995; 26: 57-65 11. Malmberg K, R y d h L, Hamsten A, el aL Effects of insulin treatment on cause-specific one-year mortality and morbidity in diabetic patients with acute myocardial infarction. Eur Heart J 1996; 17: 1337-44 12. Melmberg K, for the DIGAMI (DiabetesMelli- tus, Insulin Glucose Infusion in Acute Myocardial In- farction) Study Group. Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus.BMJ 1997;314: 1512-15 13. Miihlhauser I, Sawicki PT, Berger M. Possible risk of sulfonylureas in the treatment of non-insulin- dependent diabetes mellitus andcoronary artery disease. Diabetologia 1997; 40: 1492-93 14. Berger M, Miihlhauser I, Sawicki PT. Possible risk of sulfonylureas in the treatment of non-insulin- dependent diabetesmellitus and coronary artery disease. Diabefologiu 1998;41: 744 IS. Engler RL, Yellon DM. Sulfonylurea K , blockade in type 2 diabetes and preconditioning in car- diovascular disease. Time for reconsideration. Circu- lntion 1996;94: 2297-301 16. Cleveland JC,MeldrumDR,CainBS,etal. Oral sulphonylurea hypoglycaemic agents prevent ischemic preconditioning in human myocardium. Circularion 17. Fasching P. Possible risk of sulfonylureas in the treatment of non-insulin-dependent diabetes mellitus and coronary artery disease. Diabefologia 1998;41: 743-44 18. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose controlwith sulphonyl- mas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352: 837-53 19. Yudkin JS. Managing the diabetic patient with acute myocardial infarction. DiaberMed 1998;15:276- 81 20. MacDonaldTM,ButlerR,NewtonRW,Morris AD, for the DARTS I MEMO Collaboration. Which drugs benefit diabetic patients for secondary prevention of myocardial infarction? Diaber Med 1998; 15:282-89 21. Fibrinolytic Therapy Trialists’ (FTT) Colla- borative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than lo00 patients. Lancet 1994; 343: 3 I 1-22 22. Antiplatelet Trialiits’ Collaboration. Colla- borative overview of randomised trials of antiplatelet therapy. I. Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various 1997;%: 29-32 categoriesof patients. BMJ 1994; 308 81-106 23. Tse WY, Kendall M. Is there a role for beta blockers in hypertensive diabetic patients? Diabet Med 1994;ll: 137-44 24. Pyorala K, Pedersen TR, Kjekshus J, ef aL Cholesterol lowering with simvastatin improves prog- nosis of diabetic patients with coronary heart disease: a subgroup analysis of the Scandanavian Simvastatin Survival Study (4s). Diabetes Care 1997; 20 61 4-20 25. Fath-Ordoubadi F, Beatt KJ. Glucose-insulin- potassium therapy for treatment of acute myocardial infarction. An overview of randomised placebc-con- trolled trials. Circulation 1997; % 1152-56 26. Oliver MF, Opie LH. Effects of glucoseand fatty acids on myocardial ischaemia and arrhythmias. Lancet 1994;343: 155-58 27. Apstein CS. Glucose-insulin-potassium for acute myocardial infarction. Remarkable results from a new prospective, randomized trial. Circulation 1998;98 28. Dh R, PaolassoEA, Piegas b, era? Metabolic modulation of acute myocardial infarction. The ECLA Glucose-Insulin-Potassium Pilot Trial. Circulation 29. ShimabukuraM,NagamineF,Murakami K,et aL Chronic gliclazide treatment affects basal and post- ischemic cardiac function in diabetic rats. Gen Phur- 30. Romano G, Patti L, lnnelli F, ef ul. Insulin and sulphonylurea therapy in NIDDM patients. Are the effects on lipoprotein metabolism different even with similarbloodglucosecontrol?Diubetes 1997; 46: 1601- 06 3 1. Brash PD, Hepburn D, Walton C etal. Practical problems implementing the DIGAMI protocol. Diabet Med 1998; 15 (suppl 1): S57 2223-26 1998; 982227-34 tnac011994; 25: 697-704 The Royal College of Nursing Diabetes Nursing Forum represents diabetes nursing on a number of national groups and committees as well as withinthe RCN. ‘Who’s i n Control?’- Forum Conference 1999 I’m pleased to announce that the Forum’sAnnual Conferencewill be held from 2pm on Friday 17th to 5pm on Saturday 1 8 September at the Forte Posthouse Hotel, Birmingham City. Details are available from the RCN Conference Unit at the address below. This conference is designed for all nurses working in diabetes care, and both RCN and non-RCN members are welcome. The programme will include sessions on ‘What’sControl? from a patient, professional and educational perspective, ‘insulin resis- tance’ and ‘meeting the challenges’, with speakers from the UK and New specialist nurses in the provision of quality care, but the apparent lack of value which is sometimes placed on specialist nurses by the NHS. We are nervous but delighted to have had our submission accepted for presen- tation at such a big event. You may see us on the tv!! Guidelines on the premixing and preloading of insulin by community nursesfor patients to give at a later time These guidelines have been updated and reissued and are available from RCN Direct on 0345 726100. EducationWorking Party Work continues apace on the four groups within this Working party - namely current course availability, quality assurance, the role of the DSN and nurseprescribing. York leading workshops on strategies for effective behaviour change. Also, the tantalising question ‘do specialist nurses disempower general nurses?’, the presentation of the ForumAwardsfor Innovation in Diabetes Care, an after-dinner entertainment and of course, the not-to-be-missed AGM! Definitelyadateforthediary. Contact Lena KirtonattheConference Unit, RCN. RCN Congress, March 1999 -Matter for Discussion As I write, we will be presentinga matterfor discussionto RCN Congress on the subject of ‘only specilist nurses have the skills to facilitate effective care in chronic disease’, highlighting the need for both general and Further details of these and all the Forum’s activities, such as represen- tation ofdiabetesnursing on national working groups and committees, can beobtainedbycontactingme viaAnneSynnottat theaddress beloworon e-mailrosebud*btinternet.com Rosemary Walker, RGNFETC, Chair The Royal College of Nursing: The Voice of Nursing 20 Cavendish Square, London Wl M OAB. Telephone:01 71 409 3333 Fax: 0171 647 3435 ~ 46 Practical DiabetesInternational MarcWApril I999 Vol. 16 No. 2

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PERSONAL COMMENT Diabetes and myocardial infarction: do we have time to wait?

3. Frier BM. Diabetes and myocardial infarction. Diabetes Rev Inf 1998; 7(2): 1-2 4. Davey G,McKeigueP. Insulin infusion in diabetic

patients with acute myocardial infarction. BMJ 1996; 313 63940

5 . Nattrass M. Managing diabetes after myocardial infarction.BMJ 1997; 314: 1497 6. Gerstein HC. Insulin infusion followed by mul-

tipledaily insulin injectionsreducedmortality afterMIin diabetes. ACP Journal Club 1996; 124: 1 7. Yudkin JS. Intensive insulin regimen reduced

long-term mortality after MI in diabetes mellitus. ACP Journal Club 1997; 127: 60 8. Sackett DL. How to practice and teach evidence-

based medicine. Educational scenarios for teaching EBMinprimarycare.Oxford,UK, 1997,p154,p202 9. Malmberg KA, Efendic S, Ryden LE. Feasibility

of insulin-glucose infusionin diabetic patients with acute myocardial infarction. Diabetes Care 1994; 17: 1007-14 10. Malmberg K, Ryden L, Efendic S, et al. Ran-

domised trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAM1 Study): Effects onmortalityat 1 year. JAm CollCurdiol1995; 26: 57-65

11. Malmberg K, Rydh L, Hamsten A, el aL Effects of insulin treatment on cause-specific one-year mortality and morbidity in diabetic patients with acute myocardial infarction. Eur Heart J 1996; 17: 1337-44 12. Melmberg K, for the DIGAMI (Diabetes Melli-

tus, Insulin Glucose Infusion in Acute Myocardial In- farction) Study Group. Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus.BMJ 1997;314: 1512-15

13. Miihlhauser I, Sawicki PT, Berger M. Possible risk of sulfonylureas in the treatment of non-insulin- dependent diabetes mellitus andcoronary artery disease. Diabetologia 1997; 40: 1492-93

14. Berger M, Miihlhauser I, Sawicki PT. Possible risk of sulfonylureas in the treatment of non-insulin- dependent diabetes mellitus and coronary artery disease. Diabefologiu 1998;41: 744

IS. Engler RL, Yellon DM. Sulfonylurea K,, blockade in type 2 diabetes and preconditioning in car- diovascular disease. Time for reconsideration. Circu- lntion 1996;94: 2297-301 16. Cleveland JC,MeldrumDR,CainBS,etal. Oral

sulphonylurea hypoglycaemic agents prevent ischemic preconditioning in human myocardium. Circularion

17. Fasching P. Possible risk of sulfonylureas in the treatment of non-insulin-dependent diabetes mellitus and coronary artery disease. Diabefologia 1998; 41: 743-44 18. UK Prospective Diabetes Study (UKPDS)

Group. Intensive blood-glucose control with sulphonyl- mas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352: 837-53 19. Yudkin JS. Managing the diabetic patient with

acute myocardial infarction. DiaberMed 1998; 15: 276- 81 20. MacDonaldTM,ButlerR,NewtonRW,Morris

AD, for the DARTS I MEMO Collaboration. Which drugs benefit diabetic patients for secondary prevention of myocardial infarction? Diaber Med 1998; 15: 282-89 21. Fibrinolytic Therapy Trialists’ (FTT) Colla-

borative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than lo00 patients. Lancet 1994; 343: 3 I 1-22 22. Antiplatelet Trialiits’ Collaboration. Colla-

borative overview of randomised trials of antiplatelet therapy. I. Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various

1997;%: 29-32

categoriesof patients. BMJ 1994; 308 81-106 23. Tse WY, Kendall M. Is there a role for beta

blockers in hypertensive diabetic patients? Diabet Med 1994;ll: 137-44 24. Pyorala K, Pedersen TR, Kjekshus J, ef aL

Cholesterol lowering with simvastatin improves prog- nosis of diabetic patients with coronary heart disease: a subgroup analysis of the Scandanavian Simvastatin Survival Study (4s). Diabetes Care 1997; 2 0 61 4-20 25. Fath-Ordoubadi F, Beatt KJ. Glucose-insulin-

potassium therapy for treatment of acute myocardial infarction. An overview of randomised placebc-con- trolled trials. Circulation 1997; % 1152-56 26. Oliver MF, Opie LH. Effects of glucose and fatty

acids on myocardial ischaemia and arrhythmias. Lancet 1994;343: 155-58 27. Apstein CS. Glucose-insulin-potassium for acute

myocardial infarction. Remarkable results from a new prospective, randomized trial. Circulation 1998; 98

28. D h R, Paolasso EA, Piegas b, era? Metabolic modulation of acute myocardial infarction. The ECLA Glucose-Insulin-Potassium Pilot Trial. Circulation

29. ShimabukuraM,NagamineF,Murakami K,et aL Chronic gliclazide treatment affects basal and post- ischemic cardiac function in diabetic rats. Gen Phur-

30. Romano G, Patti L, lnnelli F, e f ul. Insulin and sulphonylurea therapy in NIDDM patients. Are the effects on lipoprotein metabolism different even with similarbloodglucosecontrol?Diubetes 1997; 46: 1601- 06

3 1. Brash PD, Hepburn D, Walton C etal. Practical problems implementing the DIGAMI protocol. Diabet Med 1998; 15 (suppl 1): S57

2223-26

1998; 98 2227-34

tnac011994; 25: 697-704

The Royal College of Nursing Diabetes Nursing Forum represents diabetes nursing on a number of national groups and committees as well as within the RCN.

‘Who’s in Control?’- Forum Conference 1999 I’m pleased to announce that the Forum’s Annual Conference will be held from 2pm on Friday 17th to 5pm on Saturday 18 September at the Forte Posthouse Hotel, Birmingham City. Details are available from the RCN Conference Unit at the address below. This conference is designed for all nurses working in diabetes care, and both RCN and non-RCN members are welcome. The programme will include sessions on ‘What’s Control? ‘ from a patient, professional and educational perspective, ‘insulin resis- tance’ and ‘meeting the challenges’, with speakers from the UK and New

specialist nurses in the provision of quality care, but the apparent lack of value which is sometimes placed on specialist nurses by the NHS. We are nervous but delighted to have had our submission accepted for presen- tation at such a big event. You may see us on the tv!!

Guidelines on the premixing and preloading of insulin by community nursesfor patients to give at a later time These guidelines have been updated and reissued and are available from RCN Direct on 0345 726100.

Education Working Party Work continues apace on the four groups within this Working party - namely current course availability, quality assurance, the role of the DSN and nurseprescribing.

York leading workshops on strategies for effective behaviour change. Also, the tantalising question ‘do specialist nurses disempower general nurses?’, the presentation of the Forum Awardsfor Innovation in Diabetes Care, an after-dinner entertainment and of course, the not-to-be-missed AGM! Definitelyadateforthediary. Contact Lena KirtonattheConference Unit, RCN.

RCN Congress, March 1999 -Matter for Discussion As I write, we will be presenting a matterfor discussion to RCN Congress on the subject of ‘only specilist nurses have the skills to facilitate effective care in chronic disease’, highlighting the need for both general and

Further details of these and all the Forum’s activities, such as represen- tation ofdiabetes nursing on national working groups and committees, can beobtainedbycontactingme via AnneSynnottat theaddress beloworon e-mailrosebud*btinternet.com

Rosemary Walker, RGNFETC, Chair

The Royal College of Nursing: The Voice of Nursing 20 Cavendish Square, London Wl M OAB. Telephone: 01 71 409 3333 Fax: 0171 647 3435

~

46 Practical Diabetes International MarcWApril I999 Vol. 16 No. 2