2Managing hyperglycaemia in patients with type 2 diabetes and known cardiovascular disease

People with type 2 diabetes are more likely to develop cardiovascular disease (CVD), and are more likely to have adverse outcomes following acute myocardial infarction (AMI). There is con-siderable uncertainty about the management of hyperglycaemia following AMI, due to the incon-sistent findings of the Diabetes Insulin Glucose Acute Myocardial Infarction (DIGAMI) studies.1,2 A number of recent randomized con-trolled trials (RCTs) also suggest that certain hyperglycaemic therapies may increase cardiovas-cular risk in diabetes subjects with known CVD.3 Moreover, some studies have raised concerns that tight glycaemic control may be deleterious in older patients with established or subclinica