However, intensive insulin therapy does not seem to be necessary to achieve the best outcomes. "Insulin does not seem to be the only solution, but tight glucose control by any means is very important." Dr. Lars Ryden from the Karolinska Institute, Stockholm, expressed.

Ryden advises doctors to "use all available tools to keep blood glucose...down."

He and his colleagues compared three glucose-control strategies -- two insulin-based and one based on standard practice -- to treat more than 1200 diabetic patients after they suffered a suspected heart attack.

Although blood glucose levels were lower with the two insulin therapies after the first 24 hours, glucose control over time did not differ among the three treatment approaches.

Also, the death rate did not significantly differ among the three treatment groups.

What did make a difference was the blood sugar level, with high glucose levels being "one of the most important prognostic predictors" of a patient dying.

Source: European Heart Journal

Electrical stimulation stops epileptic seizures
People with epilepsy, especially those who do not respond to anti-seizure medication, may one day be helped with a kind of brain pacemaker. Researchers have shown that it is possible to detect the start of an epileptic seizure and to then automatically apply high-frequency electrical stimulation (HFES) to the brain to stop the seizure progressing, according to a report in the Annals of Neurology.

Dr. Ivan Osorio from University of Kansas Medical Center, Kansas City, told that "this is a promising, cost-effective therapeutic option" for people with epilepsy who are not helped by anti-convulsants. Osorio and his colleagues investigated the safety and efficacy of automated HFES in response to seizure detection in eight patients with epilepsy. The experimental bedside set-up currently uses a couple of computers, commercial EEG equipment, and a stimulator attached to brain electrodes.

Overall, five of the subjects responded to the therapy, and the frequency of their seizures was reduced by about 80 percent.

Consciousness and behavior remained unchanged in all patients during delivery of a total of 1491 HFES events -- except for one patient who experienced transient unawareness -- the team reports.

The process "offers the hope of not only blocking seizures even before patients become aware of their onset, but also of short-term warning," Osorio concluded.

Source: Annals of Neurology