CARDIAC SYNDROMES COMPLICATING DIABETES AND THEIR TREATMENT

Abstract

Evidence is reviewed showing that diabetes mellitus is conducive to severe arteriosclerosis, and especially to coronary artery disease and coronary thrombosis. Analyses were made of 49 cases of diabetes associated with heart disease. The sexes were fairly evenly represented; avg. age of [male][male] was 62 yrs., and of [female][female] 61 yrs. Hypertension was present in 44 of the cases, and, as frequently seen, the blood pressure frequently dropped considerably on confining the patients to bed. Cardiac asthma, coronary occlusion, and angina pectoris reflect the state of the coronary arteries, but it is postulated that coronary artery disease may likewise hinder the heart in its utilization of glucose, and rapid fluctuations in blood sugar level entail sudden alteration in the nutrition of the heart. In general, patients with coronary disease or heart failure experienced benefit from any adjustment of regime or insulin dosage which tended to stabilize the blood sugar level. A reconsideration of fluid balance, diet, insulin, and remedies directed specifically to the heart in the treatment of these patients is presented. It is re-emphasized that in the diabetic cardiac, sudden reductions of blood sugar by diet or insulin is hazardous.