Society | Recommendations | Level of recommendation where available |
---|---|---|
AACE/ADA31 | Target 7.8–10.0 mmol/L most non-critical patients. | Evidence level C |
ACC/AHA32 | Treat hyperglycaemia if >10.0 mmol/L and avoid hypoglycaemia. | Downgraded recommendation for use of insulin from class 1 to class II (evidence level B) |
Canadian Diabetes Association33 | Patients with acute MI and admission glucose >11.0 mmol/L may receive glycaemic control in the range of 7.0–10.0 mmol/L. | Grade C level 2 |
Insulin may be required to achieve this target. | Grade D (consensus) | |
ESC/EASD34 | Insulin based glycaemic control should be considered in ACS patients with significant hyperglycaemia (10.0 mmol/L) with the target adapted to possible comorbidities. | Recommendation class IIa, evidence level C |
NICE35 | Keep blood glucose levels below 11.0 mmol/L. Consider intravenous insulin as a method to achieve target. | |
SIGN36 | Patients with ACS and glucose >11.0 mmol/L should have immediate blood glucose control aiming for target of 7.0–10.9 mmol/L. |
AACE = American Association of Clinical Endocrinologists; ACC = American College of Cardiology Foundation; ADA = American Diabetes Association; AHA = American Heart Association; EASD = European Association for the Study of Diabetes; ESC = European Society of Cardiology; NICE = National Institute for Health and Care Excellence; SIGN = Scottish Intercollegiate Guidelines Network.