Table III.
Design of the Randomized trials of GIK vs. control in acute myocardial infarction, and GIK regimen used
| STUDY | Year | 2N | Duration of infusion | GIK regimen |
|---|---|---|---|---|
| Mittra19 | 1965 | 170 | 14 days | Low dose: Oral or I.V.: Oral: 240 g oral glucose O.D. + 10 U SC soluble insulin B.I.D. +52–78 mEq effervescent potassium O.D., or I.V.: 21/170 patients received 10% dextrose 500 cc + 10 U soluble insulin + 20 mEq KCl infused at 40–60 drops/minutes (1.5–2 L/day) for 3–4 days, then oral dose upto 14 days, versus usual care control |
| Pilcher20 | 1967 | 102 | 14 days | Low dose: Oral: using Mittra regimen above, versus oral placebo tablets |
| Pentecost21 | 1968 | 200 | 48 h | Low dose: I.V. 10% dextrose 1500 cc + 30 U soluble insulin + 30 mEq potassium for first 24 hours; 10% dextrose 1000 cc + 30 U soluble insulin + 20 mEq potassium for second 24 hours, versus usual care control |
| M.R.C.22 | 1968 | 968 | 14 days | Low dose: Oral or I.V.: Oral: 160 g glucose in water 1500 mL per day + 20 U SC soluble insulin per day + 52 mEq potassium per day, or I.V.: 40 mL of 50% glucose, then 10% glucose in water 1500 mL per 24 hours + 30 U soluble insulin per 24 hours + 45 mEq KCl per day, versus oral placebo (starch and lactose) control |
| Hjermann23 | 1971 | 204 | 10 days | Low dose: Oral: 200 g glucose per day + 16 U long acting insulin per day + 55 mEq potassium per day, versus placebo juice containing sodium cyclamate and placebo SC insulin control |
| Heng24 | 1977 | 27 | 6–12 h | High dose: I.V.: 50% glucose (5.5 mmol/kg) infused for 10 minutes at 2.0 mL/kg + 0.4 U/kg soluble insulin, then 50% glucose (4.2 mmol/kg/hr) + 0.3 U/kg soluble insulin + 0.15 mmol/kg KCl infused at 1.5 mL/kg/hr; or 50% glucose (5.55 mmol/kg) infused at 2.0 mL/kg for 10 minutes (4.2 mmol/kg/hr), then 50% glucose infused at 1.5 mL/kg/hr (4.2 mmol/kg/hr), versus control of normal saline solution infused for 10 minutes at 2 mL/kg, then at 1.5 mL/kg/hr (4.2 mmol/kg/hr) |
| Stanley25 | 1978 | 110 | 48 h | High dose: I.V.: 300 g glucose + 50 U regular insulin + 80 mEq KCl/L infused at 1.5 mL/kg/hr, versus control solution of half-normal saline |
| Rogers26 | 1979 | 134 | 48 h | High dose: I.V.: 300 g glucose + 50 U insulin + 80 mEq potassium/L infused at 1.5 mL/kg/hr, versus control solution of half-normal saline at a rate to keep catheter patent |
| Mantle27 | 1981 | 85 | 48 h | High dose: I.V.: 300 g glucose + 50 U insulin + 80 mEq KCl/L infused at 1.5 mL/kg/hr for 48 hrs, then 0.45% NaCl + 5000 U/L heparin at “keep open” rate of 20 mL/hr through CV and PA lumen for one day, versus control of same heparinized 0.45% NaCl solution through both lumens of catheter at “keep open” rate for whole study period (3 days) |
| Whitlow28 | 1982 | 28 | 48 h | High dose: I.V.: 300 g glucose + 50 U regular insulin + 80 mEqKCL/L infused at 1.5 mL/kg/hr for 48 hrs, then 0.45% NaCl for 2 days at 20 mL/hr, versus control of 0.45% NaCl at 20 mL/hr for 4 days |
| Salter29 | 1987 | 17 | 48 h | High dose: I.V.: 300 g glucose + 50 U regular insulin + 80 mEq potassium/L infused at 1.5 mL/kg/hr versus control of 5% dextrose in water at 1.5 mL/kg/hr |
| Malmberg30 | 1995 | 620 | 24 h | High dose: I.V.: 5% glucose 500 cc + 80 U soluble insulin (no potassium) infused at 30 mL/hr and rate adjusted to blood glucose nomogram, then s.c. soluble insulin 3 times daily and medium-long acting insulin once daily for 3 months with dosage for stable normoglycemia, versus usual care only (insulin if clinically indicated) |
| Diaz31 | 1998 | 407 | 24 h | Low or High dose: I.V.: Low dose: 10% glucose + 20 U insulin + 40 mmol KCL infused at 1.0 mL/kg/hr/hr High dose: 25% glucose + 50 U soluble insulin + 80 mmol KCL infused at 1.5 mL/kg/hr versus usual care control |
| Ceremuzynski32 | 1999 | 962 | 24 h | Low dose I.V.: 10% dextrose 1000 mL + 32 U rapid insulin + 20 U Humulin R insulin (mixed insulin for only 369/954 patients; due to hypoglycemia, remaining patients received only 20 U short-acting Humulin R in infusion) + 6.0 g potassium chlorate infused at 42 mL/hr, versus control of 0.9% NaCl 1000 mL at 42 mL/h for 24 hrs |
| Diaz-Araya33 | 2002 | 20 | 24 h | High dose: I.V.: 30% glucose + 50 U insulin + 40 mM KCl/L infused at 1.5 mL/kg/hr versus control of normal saline solution at 1.5 mL/kg/hr |
| van der Horst34 | 2003 | 940 | 8–12 h | High dose: I.V.: 20% glucose in 500 mL water + 80 mmol KCl infused at 3.0 mL/kg/hr, with infusion of 50 U short-acting insulin in 50 mL 0.9% NaCl with infusion rate adjusted to blood glucose nomogram versus control of no infusion |