A therapeutic approach to hyperglycaemia in the setting of acute myocardial infarction: spotlight on glucagon-like peptide 1.

Patients with acute myocardial infarction (AMI) frequently have abnormalities of glucose metabolism and insulin resistance, both of which are associated with a poor outcome. Glucagon-like peptide 1 (GLP-1) is a naturally occurring incretin with both insulinotropic and insulinomimetic properties which not only controls glucose levels but also has potential beneficial actions on the ischaemic and failing heart. In this review we highlight the underlying pathophysiological mechanisms for the development of hyperglycaemia in AMI, speculate on the potential relationship between GLP-1 and sphingosine-1-phosphate, and review the literature on the role of GLP-1 as an important approach to treating hyperglycaemia in the setting of AMI.