In which of the following intensive management of diabetes needed except:

Answer is D (DM with Acute MI): Cardiovascular disease is increased in patient with Diabetes, but there is no evidence to suggest that improved glycemic control with intensive management reduces cardiovascular complications in DM. `Proof that improved glycemic control reduces cardiovascular complications in DM is lacking; in fact it is possible that macrovascular complications may be unaffected or even worsened by such therapy' - Harrison 16th/2167 Indications for Intensive Diabetes Management Otherwise healthy adults with either type 1 or 2 diabetes (selected adolescents and older children) Purposeful, therapeutic attempt to avoid or lessen microvascular complications All pregnant women with diabetes; all women with diabetes who are planning pregnancy Management of labile disease Availability of health care professionals with appropriate expeise Patients who have had kidney transplantation for diabetic nephropathy Autonomic Neuropathy is a microvascular complication and intensive management for glycemic control should be pursued to improve nerve conduction (Harrison 16th/2166) Impaired glycemic control (intensive management) should be the primary goal.'