Available online at www.sciencedirect.com Diabetes & Metabolism 38 (2012) 113–127 Review Consensus statement on the care of the hyperglycaemic/diabetic patient during and in the immediate follow-up of acute coronary syndrome B. Vergès a,∗ , A. Avignon b , F. Bonnet c , B. Catargi d , S. Cattan e , E. Cosson f , G. Ducrocq g , M. Elbaz h , A. Fredenrich i , P. Gourdy j , P. Henry k , O. Lairez h , A.M. Leguerrier c , C. Monpère l , P. Moulin m , B. Vergès-Patois n , R. Roussel o , G. Steg g , P. Valensi f , Diabetes and Cardiovascular Disease study group of the Société francophone du diabète (SFD), in collaboration with the Société fran¸ caise de cardiologie (SFC) a Service d’endocrinologie, diabétologie et maladies métaboliques, hôpital du Bocage, CHU, 21000 Dijon, France b Service des maladies métaboliques, CHU de Montpellier, 34000 Montpellier, France c Service d’endocrinologie, diabétologie et nutrition, CHU de Rennes, 35000 Rennes, France d Service d’endocrinologie, CHU de Bordeaux, 33000 Bordeaux, France e Service de cardiologie, CHI de Le Raincy-Montfermeil, 93370 Le Raincy-Montfermeil, France f Service d’endocrinologie, diabétologie et nutrition, CHU Jean-Verdier, 93140 Bondy, France g Service de cardiologie, CHU Bichat, 75018 Paris, France h Service de cardiologie, CHU de Toulouse, 31059 Toulouse, France i Service de diabétologie-endocrinologie, CHU de Nice, 06002 Nice, France j Service de diabétologie, maladies métaboliques, nutrition, CHU de Toulouse, 31059 Toulouse, France k Service de cardiologie, CHU Lariboisière, 75010 Paris, France l Service de réadaptation cardiaque, 37510 Bois-Gibert, France m Service d’endocrinologie et maladies de la nutrition, hôpital cardiologique Louis-Pradel, CHU de Lyon, 69677 Bron, France n Service de réadaptation cardiaque, Les Rosiers, 21000 Dijon, France o Service de diabetologie-endocrinologie et nutrition, CHU Bichat, 75018 Paris, France Received 23 November 2011; accepted 24 November 2011 Abstract The Diabetes and Cardiovascular Disease study group of the Société francophone du diabète (SFD, French Society of Diabetes) in collaboration with the Société fran¸ caise de cardiologie (SFC, French Society of Cardiology) have devised a consensus statement on the care of the hypergly- caemic/diabetic patient during and in the immediate follow-up of acute coronary syndrome (ACS); in particular, it includes the different phases of ACS [the intensive care unit (ICU) period, the post-ICU period and the short-term follow-up period after discharge, including cardiac rehabilitation] and also embraces all of the various diagnostic and therapeutic issues with a view to optimalizing the collaboration between cardiologists and diabetologists. As regards diagnosis, subjects with HbA 1c greater or equal to 6.5% on admission may be considered diabetic while, in those with no known diabetes and HbA 1c less than 6.5%, it is recommended that an OGTT be performed 7 to 28 days after ACS. During hospitalization in the ICU, continuous insulin treatment should be initiated in all patients when admission blood glucose levels are greater or equal to 180 mg/dL (10.0 mmol/L) and, in those with previously known diabetes, when preprandial glucose levels are greater or equal to 140 mg/dL (7.77 mmol/L) during follow-up. The recommended blood glucose target is 140–180 mg/dL (7.7–10 mmol/L) for most patients. Following the ICU period, insulin treatment is not mandatory for every patient, and other antidiabetic treatments may be considered, with the choice of optimal treatment depend- ing on the metabolic profile of the patient. Patients should be referred to a diabetologist before discharge from hospital in cases of unknown diabetes diagnosed during ACS hospitalization, of HbA 1c greater or equal to 8% at the time of admission, or newly introduced insulin therapy or severe/repeated hypoglycaemia. Referral to a diabetologist after hospital discharge is recommended if diabetes is diagnosed by the OGTT, or during cardiac rehabilitation in cases of uncontrolled diabetes (HbA 1c ≥ 8%) or severe/repeated hypoglycaemia. © 2012 Elsevier Masson SAS. All rights reserved. Keywords: Diabetes; Acute coronary syndrome; Myocardial infarction; Consensus; Cardiology; Hyperglycaemia; Review ∗ Corresponding author. Tel.: +33 03 80 29 34 53; fax: +33 03 80 29 35 19. E-mail address: bruno.verges@chu-dijon.fr (B. Vergès). 1262-3636/$ – see front matter © 2012 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.diabet.2011.11.003 © 2021 Elsevier Masson SAS. Tous droits réservés. - Document téléchargé le 27/11/2021 Il est interdit et illégal de diffuser ce document.