Beuy Joob1, Viroj Wiwanitkit2. 1. Sanitation 1 Medical Academic Center, Bangkok, Thailand. 2. Tropical Medicine Unit, Hainan Medical University, Hainan, China.
Sir,Diabetes mellitus (DM) is the global public health threat. The early detection for DM by screening is accepted as effective secondary prevention. For the patients with acute coronary syndrome (ACS), the screening is proved to be useful. The screening is recommended by National Institute for Health and Care Excellence (NICE) criteria.[1] NICE guidelines noted that all ACS patients with admission blood glucose concentrations above 11.0 mmol/l should have a fasting plasma glucose determination no earlier than day 4 after onset or have an HbA1c test before discharge.[23]” The coverage and cost of the screening alternative are the big concern. McCune et al. mentioned that the universal coverage screening can be cost effective.[3] However, the concern on the coverage is still the issue to be investigated. Based on the previous report by McCune et al., using NICE criteria, 1 from 7 cases accepted for further screening whereas 26 from 49 cases accepted universal screening.[3] Based on this information, it can also confirm that the coverage of universal screening is better than the practice based on NICE criteria. Hence, it is confirmed that universal coverage screening for DM must be implemented for any ACS patients.