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Screening for undiagnosed diabetes in patients with acute myocardial infarction

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Abstract

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 CKMAX, 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.

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Authors and Affiliations

  1. German Diabetes Center Leibniz Center at Heinrich Heine University, Auf́m Hennekamp 65, 40225, Düsseldorf, Germany

    Mark Lankisch & Stephan Martin

  2. Heart Center Wuppertal Helios-Kliniken, Wuppertal, Germany

    Mark Lankisch, Reiner Füth, Hartmut Gülker & Alexander Bufe

  3. Helios-Klinikum Erfurt, 3. Medizinische Klinik, Erfurt, Germany

    Harald Lapp

  4. Institute of Biometrics and Epidemiology, German Diabetes Center Leibniz Center at Heinrich Heine University, Düsseldorf, Germany

    Burkhard Haastert & Wolfgang Rathmann

Authors
  1. Mark Lankisch
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  2. Reiner Füth
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  3. Hartmut Gülker
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  4. Harald Lapp
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  5. Alexander Bufe
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  6. Burkhard Haastert
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  7. Stephan Martin
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  8. Wolfgang Rathmann
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Corresponding author

Correspondence to Stephan Martin.

Additional information

M. Lankisch and R. Füth equally contributed to this work.

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Lankisch, M., Füth, R., Gülker, H. et al. Screening for undiagnosed diabetes in patients with acute myocardial infarction. Clin Res Cardiol 97, 753–759 (2008). https://doi.org/10.1007/s00392-008-0674-5

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  • DOI: https://doi.org/10.1007/s00392-008-0674-5

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