Finally, a national sample of 141,680 elderly patients with acute MI showed that at least patients who are known to have diabetes seem to be receiving more aggressive care than in years past. On admission, 30% had documented diabetes, whereas substantial proportions of those who entered with elevated glucose did not have that diagnosis.
While in the hospital, 73% of diabetic patients who came in with a glucose level above 240 mg/dL were treated with insulin, compared with 22% of those with the same level of hyperglycemia who did not have the diabetes diagnosis. Though 30-day and 1-year mortality increased with higher glucose levels at admission in both groups, the effect was much greater in those without known diabetes: For them, the increased mortality began at values of 110 mg/dL, while in the diabetic group the difference in mortality was seen only in those with admission glucose levels above 240 mg/dL (Circulation 2005;111:3078–86).