BMJ 1997;315:544 (30 August)

Letters

Intensive insulin treatment after acute myocardial infarction in diabetes mellitus

Evidence exists from study of non-insulin dependent diabetes in Japan

Editor–In his editorial prompted by the publication of the DIGAMI (diabetes mellitus, insulin glucose infusion in acute myocardial infarction) trial,1 Malcolm Nattrass states that (in non-insulin dependent diabetes) "evidence [is] still awaited for a relation between diabetic control and microvascular complications."2 It is true that we all await with interest the results of the United Kingdom prospective diabetes study, but some evidence does already exist. Although it is not directly relevant to Nattrass's editorial, in other contexts I have been surprised that it is rarely discussed and is almost never referenced in publications written by authors working on diabetes outside Asia and Australasia.

The study to which I refer is the Kumamoto study.3 This randomised 110 patients with non-insulin dependent diabetes (half with existing microvascular complications and half without) into a group treated with multiple injections and a group given . . . [Full text of this article]


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