4 Research recommendations

The Guideline Development Group has made the following recommendation for research, based on its review of evidence, to improve NICE guidance and patient care in the future.

4.1 Optimal management of hyperglycaemia in ACS

What is the optimal management of hyperglycaemia in people with acute coronary syndrome who have diagnosed or previously undiagnosed diabetes?

Why this is important

Existing studies on the optimal management of hyperglycaemia in people who have ACS and diagnosed or previously undiagnosed diabetes are generally of poor quality.

It is recommended that a large randomised controlled trial is conducted for people with ACS and hyperglycaemia (blood glucose 11 mmol/litre and over) stratified by NSTEMI and STEMI and by known diabetes and without a previous diagnosis of diabetes.

The interventions for the trial should be intravenous insulin or subcutaneous insulin administered within 4 hours of presentation to hospital. The aim is to achieve blood glucose between 6 and 11 mmol/litre for at least 24 hours. The comparator should be standard care.

  • National Institute for Health and Care Excellence (NICE)