REsearching Coronary REduction by Appropriately Targeting Euglycemia (RECREATE Pilot Study) (RECREATE Pilot)

Inclusion Criteria:

Both nondiabetic patients and patients with non-insulin-requiring type 2 diabetes mellitus admitted with a suspected AMI are eligible if they meet the following criteria:

• Signs or symptoms of AMI with definite ECG changes, defined as persistent ST-segment elevation (> or = than 1 mm)in two or more contiguous leads, or new left bundle branch block
• Onset of symptoms within 24 hours before hospital presentation
• Capillary blood glucose level on presentation > or = 8.0 mmol/L (144 mg/dL)

Exclusion Criteria:

• Patient with conditions that REQUIRE the administration of insulin, including:

  • Type 1 diabetes mellitus, defined by a documented history of diabetes mellitus before the age of 30
  • Type 2 diabetes mellitus that was treated with insulin prior to AMI presentation
  • Type 2 diabetes mellitus that is known to be very poorly controlled (e.g. admission capillary blood glucose > 16.0 mmol/L (288 mg/dL)or marked elevation in glucose for which the site investigator plans to treat with insulin therapy)
• A history of severe hypoglycemic episodes (defined as hypoglycemia with symptoms which the patient is unable to reverse without the assistance of another person) within the past two years
• Known or suspected end-stage liver disease (due to the risk of hypoglycemia in the setting of liver dysfunction and consequent impaired regulation of glucose homeostasis)
• Cardiogenic shock on admission (due to the inaccuracy of glucose meter readings)
• Documented pregnancy
• Any concomitant disease (e.g. cancer) that might limit life expectancy to less than 90 days
• Anticipated poor adherence with study treatments or an other factor that might jeopardize 90-day follow-up (e.g. no fixed address, long distance to hospital, etc.)
• Prior enrollment in this trial or current enrollment in another trial of ST-segment elevation myocardial infarction