A cheap and simple solution of glucose, insulin and potassium, commonly used 35 years ago, was reinvestigated in a recent study and found to be effective in preventing death from heart attacks.

In a multicentre trial conducted in Latin America, 407 patients were randomly placed into one of three groups: high dose, who received a solution of 25 per cent glucose, 50 IU/l insulin and 80mmol potassium chloride; low dose, who received a solution of 10 per cent glucose, 20 IU/l insulin and 40mmol potassium chloride; and controls.

Doctors, who were allowed to use other measures, such as thrombolytic drugs or angioplasty when considered necessary, did so in 252 patients across all three groups. All patients receiving the glucose/ insulin/potassium solution had a death rate of 6.7 per cent, as compared with 11.5 for those in the control group. When the infusion was used in conjunction with other treatments, the overall risk of dying fell from 15.2 per cent to 5.2 per cent.

The high dose solution was superior to the low dose one, and the benefit carried on during the one year follow up.

The treated groups also had fewer complications, such as ventricular fibrillation, heart failure, and elecro mechanical dissociation. (BMJ, 1998; 317: 1546).