DIABETES, MYOCARDIAL INFARCTION, –METFORMIN v s. INSULIN

DIABETES, MYOCARDIAL INFARCTION—METFORMIN  VS. INSULIN
QUESTION: In case of a patient with type 2 diabetes who hav made a myocardial infraction or he is on secondary prevention and he was on metformine only and his diabetes was well equilibrated (HBA1c =7p100), is there an obligation to put patient on insuline therapy because he is on secondary prevention , or is there a necessity to stop metformine in this case of myocardial infraction (patient is not on acute phase of MI )    Dr Nadjib Kaouache ,Universitary   Hospital. Constantine  . Algeria
RESPONSE--In a type 2 diabetic patient with history of myocardial infarction, you can continue metformin therapy. It is only during periods of tissue hypoxia (acute myocardial infarction, sepsis) when metformin should be withheld. It is not necessary to put the patient on insulin therapy if he is well controlled on metformin alone. Patricia Juang, MD,  Robert Henry, MD