DIGAMi 1: New Study Says Diabetics Need Insulin, Not Pills, To Recover From Heart Attacks

In 1945, the renowned cardiologist Demetrio Sodi-Pallares made a remarkable discovery. Treating heart attack patients with a combination of potassium, glucose, and insulin sometimes brought them completely back to health. Over the years, Sodi-Pallares used his position as a professor of medicine first at UCLA, then at Michigan, and then at the Baylor School of Medicine almost as an evangelist for the simple method of treatment.

And in 1998, fifty-three years later, the American Heart Association begrudgingly acknowledged to the then 85-year-old Dr. Sodi-Pallares that his method did work, when there was no danger of its replacing bypass surgery as the treatment of choice.

The DIGAMi-1 Study of Heart Attack Survival in Diabetics

The Diabetes Mellitus Insulin Glucose Infusion in Acute Myocardial Infarction (DIGAMI 1) was a study conducted in 19 Swedish hospitals between January of 1990 and January of 1993. Heart attack patients who also had type 2 diabetes and high blood sugar levels, over 11 mmol/L (199 mg/dl in the American system) were randomly assigned into two groups. One group was given standard heart attack care and the usual oral medications for type 2 diabetes. The other group was given standard heart attack care and put on intensive insulin therapy for 3 months to keep their blood sugar levels low as their hearts healed.

Then both groups were followed for the next 20 years. There were significant differences in survival between the two groups.

• One of the patients in the insulin treatment group survived another 20 years and 9 months after heart attack.
• Half of the patients treated with oral medications lived for 4 years and 8 months or longer after their heart attacks.
• Half of the patients treated with insulin, just for 3 months, lived another 7 years after their heart attacks.

But some patients benefited from insulin therapy a lot more than others.

• In patients who were under the age of 70 when they had their heart attacks, who had no prior insulin treatment, and no history of congestive heart failure, the median survival time was 9.4 years with insulin treatment, compared to 6.9 years without it.
• In patients who were over the age of 70,or who had a history of cardiovascular disease other than heart attack, or who already had diabetic complications, adding insulin therapy for 3 months did not increase longevity.

That does not mean, however, that treating type 2 diabetes with insulin over the long term would be a bad idea.

Follow-up care for heart attack patients has greatly improved since 1993. People who have heart attacks are routinely given ACE-inhibitors (drugs such as captopril, lisinopril, or ramipril) to control blood pressure.

See Also: Insulin: The Only Medication For Diabetes That Always Work

Moreover, it short-circuits a cellular signal called mTOR, which powers the proliferation of cells that have become cancerous, and reduces the risk of diabetic kidney disease. This simple, readily available, extremely inexpensive medication not only protects the heart but also reduces the risk of cancer and kidney disease.

Blood Sugar Control Is One More Way To Maintain Heart Health

Nowadays heart attack patients are also given multiple medications for blood pressure, modern anticoagulants plus Aspirin for preventing blood clots, and multiple medications for diabetes. Aspirin helps prevent inflammation, which reduces the risk of both heart disease and cancer.

Heart, Diabetes Meds May Also Help Prevent Cancer

The commonly prescribed generic medications for heart attack patients, none of them costing more than $10 per month, protect health in more ways than just protecting the heart. The scientists who conducted the DIGAMi-1 study agree that heart attack patients today can expect to live much longer now than they could in 1993. However, as Dr. Denise Bonds of the National Institutes of Health in the USA commented on the study:

"First, it points to the benefit of good glucose control even when other risk factors such as lipids or blood pressure cannot be or are not modified. Participants in the intensively treated group had a reduction in HbA1c of about 0.6%, an important and sizable reduction," she noted.

"Second...it provides an important reminder of how quickly medicine is advancing....In 20 years, we have gone from few glucose lowering-therapies to over half a dozen oral therapy drugs, plus insulin, plus effective treatments to reduce the risk of elevated lipids and blood pressure."

"Now, the challenge is choosing the best treatment option for our patients. We've come a long way," she concludes.

Tight Control of Diabetes May Be an Ongoing Need

In other words, it definitely helps to control cholesterol and blood pressure. it also helps to control blood sugar levels, and to control them very carefully, with insulin. 

So, if you are a diabetic, and you have had a heart attack, what do you need to do to have the longest possible healthy and enjoyable life?

• Take all the medications your doctor prescribes. Healing without medication is a great thing if you have a mild illness. But if you have already had a heart attack, you really need standard medications.
• Make sure your doctor is prescribing at least an ACE-inhibitor, a beta-blocker, and metformin. These drugs have surprisingly anti-aging and life-extension benefits beyond just controlling blood pressure and blood sugars.
• Take the plunge and use insulin to help control your blood sugar levels.

See Also: Insulin Allergy and Insulin Resistance

To use insulin effectively, you will also have to get into the habit of taking your blood sugar levels several times a day. It takes dedication, but diabetics who monitor their blood sugar levels live longer, too. Every shot of insulin used to keep blood sugar levels on an even keel benefits the heart.

And when you are in the hospital getting treatment for a heart attack, insist on good blood sugar control. Many cardiology wards still don't have the protocols in place for monitoring and controlling blood sugar in their diabetic patients. You have to have blood sugar control to survive. Make sure your hospital provides it for you.