Editorial
Glucose, insulin, and the cardiovascular system
| The first 150 words of the full text of this article appear below. |
There is increasing evidence to support the beneficial effects of glucose-insulin-potassium infusions (GIK) in acute myocardial infarction, cardiogenic shock, and cardiac surgery. An article in this issue suggests some benefits may also accrue during the treatment of chronic heart failure.1
Background physiologyThe use of GIK to improve ischaemic cardiac dysfunction has been
based on two principles. First, insulin stimulates myocardial Na+ K+ ATPase, increasing reuptake of
K+, stabilising the cell membrane, and reducing the
incidence of dysrrhythmias. Second, insulin stimulates the myocardial
uptake of glucose, increasing the provision of intracellular substrate. However the significance of the relatively small increase in ATP, which
GIK produces by enhancing anaerobic oxidation of glucose, has been
questioned. The evidence for attenuation of ischaemia induced reduction
in ATP stores is scanty. Nevertheless, recent work suggests that the
position of the glycolytic enzymes within the cell may ensure that the
little ATP that is
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This article has been cited by other articles:
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Hamdulay, S. S., Khafaji, A. A., Montgomery, H.
(2006). Glucose-Insulin and Potassium Infusions in Septic Shock. Chest
129: 800-804
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