BACKGROUND: Screening for undiagnosed diabetes in patients with acute myocardial infarction is recommended (ESC and EASD Task Force 2007). Glucose tolerance testing in the peri-infarct period may not be valid because of confounding, e.g. by the acute stress reaction. The aim was to evaluate undiagnosed diabetes (DM) and impaired glucose regulation (IGR) in AMI during hospital stay and 3 months after discharge. MATERIALS AND METHODS: In 96 consecutively admitted AMI patients (Heart Center Wuppertal, Germany) OGTT were performed, of whom in 62 OGTT were also carried out 3 months later. RESULTS: Before discharge 32% of the patients had newly diagnosed diabetes and 47% patients had prediabetes (IGR). Glucose tolerance was normal in 20 (21%) patients only. After 3 months, 74% with newly diagnosed DM at baseline still had disturbed glucose metabolism (58% DM, 16% IGT). No patient with normal OGTT became diabetic after 3 months. In multivariate regression, the odds of having diabetes (3 months) was about sixfold higher when having diabetes before discharge (OGTT). Admission glucose, infarction size CK(MAX), and inflammation (CRP) were not significantly related to OGTT results. CONCLUSIONS: This prospective study confirms a high prevalence of undiagnosed DM in patients with AMI. In about 60% of AMI patients, newly diagnosed DM persisted after 3 months. For the first time we could show that there is no correlation between infarction size and undiagnosed diabetes. Thus, an OGTT performed before discharge may provide a reliable measure of disturbed glucose regulation but needs to be repeated.
BACKGROUND: Screening for undiagnosed diabetes in patients with acute myocardial infarction is recommended (ESC and EASD Task Force 2007). Glucose tolerance testing in the peri-infarct period may not be valid because of confounding, e.g. by the acute stress reaction. The aim was to evaluate undiagnosed diabetes (DM) and impaired glucose regulation (IGR) in AMI during hospital stay and 3 months after discharge. MATERIALS AND METHODS: In 96 consecutively admitted AMI patients (Heart Center Wuppertal, Germany) OGTT were performed, of whom in 62 OGTT were also carried out 3 months later. RESULTS: Before discharge 32% of the patients had newly diagnosed diabetes and 47% patients had prediabetes (IGR). Glucose tolerance was normal in 20 (21%) patients only. After 3 months, 74% with newly diagnosed DM at baseline still had disturbed glucose metabolism (58% DM, 16% IGT). No patient with normal OGTT became diabetic after 3 months. In multivariate regression, the odds of having diabetes (3 months) was about sixfold higher when having diabetes before discharge (OGTT). Admission glucose, infarction size CK(MAX), and inflammation (CRP) were not significantly related to OGTT results. CONCLUSIONS: This prospective study confirms a high prevalence of undiagnosed DM in patients with AMI. In about 60% of AMI patients, newly diagnosed DM persisted after 3 months. For the first time we could show that there is no correlation between infarction size and undiagnosed diabetes. Thus, an OGTT performed before discharge may provide a reliable measure of disturbed glucose regulation but needs to be repeated.
Authors: Lars Rydén; Eberhard Standl; Małgorzata Bartnik; Greet Van den Berghe; John Betteridge; Menko-Jan de Boer; Francesco Cosentino; Bengt Jönsson; Markku Laakso; Klas Malmberg; Silvia Priori; Jan Ostergren; Jaakko Tuomilehto; Inga Thrainsdottir; Ilse Vanhorebeek; Marco Stramba-Badiale; Peter Lindgren; Qing Qiao; Silvia G Priori; Jean-Jacques Blanc; Andrzej Budaj; John Camm; Veronica Dean; Jaap Deckers; Kenneth Dickstein; John Lekakis; Keith McGregor; Marco Metra; João Morais; Ady Osterspey; Juan Tamargo; José Luis Zamorano; Jaap W Deckers; Michel Bertrand; Bernard Charbonnel; Erland Erdmann; Ele Ferrannini; Allan Flyvbjerg; Helmut Gohlke; Jose Ramon Gonzalez Juanatey; Ian Graham; Pedro Filipe Monteiro; Klaus Parhofer; Kalevi Pyörälä; Itamar Raz; Guntram Schernthaner; Massimo Volpe; David Wood Journal: Eur Heart J Date: 2007-01 Impact factor: 29.983
Authors: M Lankisch; R Füth; D Schotes; B Rose; H Lapp; W Rathmann; B Haastert; H Gülker; W A Scherbaum; Stephan Martin Journal: Clin Res Cardiol Date: 2006-01-16 Impact factor: 5.460
Authors: Artur Dziewierz; Dawid Giszterowicz; Zbigniew Siudak; Tomasz Rakowski; Jacek S Dubiel; Dariusz Dudek Journal: Clin Res Cardiol Date: 2010-05-11 Impact factor: 5.460
Authors: Christoph J Jensen; Holger C Eberle; Kai Nassenstein; Thomas Schlosser; Mani Farazandeh; Christoph K Naber; Georg V Sabin; Oliver Bruder Journal: Clin Res Cardiol Date: 2011-02-24 Impact factor: 5.460
Authors: Deborah J Wexler; David M Nathan; Richard W Grant; Susan Regan; Allison L Van Leuvan; Enrico Cagliero Journal: J Clin Endocrinol Metab Date: 2008-08-12 Impact factor: 5.958
Authors: Eva C Knudsen; Ingebjørg Seljeflot; Michael Abdelnoor; Jan Eritsland; Arild Mangschau; Harald Arnesen; Geir O Andersen Journal: Cardiovasc Diabetol Date: 2009-01-30 Impact factor: 9.951