Comparison of diagnostic criteria to detect undiagnosed diabetes in hyperglycaemic patients with acute coronary syndrome

Abstract

79% of hyperglycaemic patients with ACS were found to have abnormal glucose metabolism. As APG, HbA1c and FPG had a low sensitivity to detect undiagnosed diabetes, an OGTT appears to be the best test to assess the presence of previously undiagnosed diabetes or impaired glucose metabolism in hyperglycaemic patients with ACS.

Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: Long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort

“…HbA 1c is considered easier and more convenient to perform while an oral glucose tolerance test (OGTT) will identify more individuals at risk. [5][6][7] In patients with acute myocardial infarction (AMI), an OGTT performed within a week after the event reveals that at least 60% of them have previously unknown abnormal glucose tolerance (AGT -either newly detected diabetes or IGT). [8][9][10] These individuals are at increased risk for cardiovascular events during the next 1-2 years, [11][12][13] but information on the long-term prognostic impact of screen detected AGT is lacking.…”

Screening for Type 2 Diabetes Risk Factors in a Greek Municipality towards Health-literate Healthcare

“…[32,33] In CVD patients, no diabetes risk score is needed but an OGTT is indicated if HbA1c and/or FPG are inconclusive, since people belonging to these groups may often have DM revealed only by an elevated 2hPG. [34][35][36][37] In many countries of the world (E.U., U.S.A., ASIA) high prevalence of major risk factors like smoking, bad dietary habits, lack of exercise, alcohol, obesity, arterial hypertension was reported. Recent studies proved that in the U.S.A. and Canada the level of knowledge of health risk factors was very good, but, there was an insufficient knowledge about healthy diet.…”

“…However, most previous studies have been conducted in European countries with the majority of participants as Caucasians [22][23][24][25][26][27][28] or other single racial groups [20], [29][30][31][32][33][34][35].…”

“…Fourth, FINDRISC has been evaluated in detecting individuals with undiagnosed diabetes and prediabetes in a cross-sectional study not only in Finland [21] but also in 15 other countries or regions and gained good validity in most of these populations [20], [22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Wytyczne ESC dotyczące cukrzycy, stanu przedcukrzycowego i chorób układu sercowo- -naczyniowego opracowane we współpracy z EASD

“…W populacji ogólnej i w przypadku osób z podejrzeniem zaburzeń metabolicznych odpowiednią strategią postępowania przesiewowego jest rozpoczęcie od skali oceny ryzyka rozwoju cukrzycy oraz wykonanie u osób z wysoką punktacją OGTT lub oznaczenie HbA 1c i FPG [36,37]. U pacjentów z CVD nie ma potrzeby przeprowadzania oceny ryzyka cukrzycy, wskazane jest jednak wykonanie OGTT, jeśli wyniki pomiaru HbA 1c i/lub FPG są niejednoznaczne, ponieważ u osób należących do tej grupy cukrzyca często manifestuje się jedynie jako podwyższenie wartości 2hPG [38][39][40][41].…”