Undiagnosed Diabetes and Prediabetes in Patients with Chronic Coronary Syndromes—An Alarming Public Health Issue

Abstract

Dysglycemia is a public health challenge for the coming decades, especially in patients with chronic coronary syndromes (CCS). We want to assess the prevalence of undiagnosed diabetes mellitus (DM) and prediabetes, as well as identify factors associated with the development of dysglycaemia in patients with CCS. In total, 1233 study participants (mean age 69 ± 9 years), who, between 6 and 18 months earlier were hospitalized for acute coronary syndrome or elective revascularization, were examined (71.4% men). The diagnosis of DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) have been made according to World Health Organization (WHO) criteria. Based on the oral glucose tolerance test (OGTT) results, DM has been newly diagnosed in 28 (5.1%, mean age 69.9 ± 8.4 years) patients, 75% were male (n = 21). Prediabetes has been observed in 395 (72.3%) cases. IFG was found in 234 (42.9%) subjects, 161 (29.5%) individuals had IGT. According to multinomial logistic regression, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) should be considered when assessing risk of development of dysglycaemia after discharge from the hospital. Among people with previously diagnosed DM, a significantly higher percentage were willing to change their lifestyles after the index event compared to other patients. Patients with chronic coronary syndromes suffer a very high frequency of dysglycaemia. Most patients with chronic coronary syndromes, especially those with high BMI or low HDL-C, should be considered for screening for dysglycemia using OGTT within the first year after hospitalization. A higher percentage of patients who were aware of their diabetic status changed their lifestyles, which added the benefit of timely diagnosis and treatment of diabetes.

Dietary Total Antioxidant Capacity Is Inversely Associated with Prediabetes and Insulin Resistance in Bialystok PLUS Population

“…In Poland diabetes affects 8.1% of the population [ 1 ]. The occurrence of T2DM in Poland is particularly high among patients with coronary artery disease [ 2 ].…”

The prevalence of diabetes and prediabetes: a population-based study

“…Despite increasing public awareness of the complications arising from hyperglycemia, diabetes often remains low-symptomatic and therefore undiagnosed. Referring to recent data from Polish patients with chronic coronary syndrome (CCS), the prevalence of dysglycemia, both diagnosed and undiagnosed, remains very high [4]. The data demonstrated as many as 43% participants had histories of diabetes of which 27 (5.6%) patients were diagnosed after hospitalization due to cardiovascular reasons.…”

“…Undiagnosed diabetes occurred in 5.1% of the respondents. Prediabetes (72.4%) emerged as an alarming concern and included 29.5% of those with IGT [4].…”

The burden of cardiovascular disease risk factors: A current problem

“…In POLASPIRE participants, only 15% had BMI <25 kg/m 2 and 42% were obese [54]. The high and rising prevalence of obesity explains at least partially why about half of CHD patients have diabetes, out of whom 31% were treated with antidiabetic agents, and the remaining 22% had fasting glucose concentration >7,0 mmol/l [47,55].…”