High prevalence of undiagnosed impaired glucose regulation and diabetes mellitus in patients scheduled for an elective coronary angiography.
BACKGROUND
Impaired glucose regulation (IGR) and diabetes mellitus (DM) are amongst the main risk factors for developing coronary heart disease (CHD). The aim of this study was to investigate previously unknown glucose metabolism disorder in patients scheduled for an elective coronary angiography.


METHODS
A total of 141 patients scheduled for coronary angiography without signs of acute myocardial ischemia or previous history of a glucose metabolism disorder were prospectively included in the study. An oral glucose tolerance test (OGTT) was performed in each patient.


RESULTS
IGR was diagnosed in 40.4% (95% confidence interval 32.3-49.0) and undetected DM in 22.7% (16.1-30.5) of patients undergoing an elective coronary angiography. Depending on the severity of CHD, the percentage of IGR and DM increased up to 45.3% (34.6-56.5) and 26.7% (17.8-37.4) in the subgroup with the need of percutaneous angioplasty, while the corresponding proportions in the group without CHD were 30.3% (15.6-48.7) and 12.1% (3.4-28.2). The percentage of undiagnosed DM increased with the number of epicardial vessels involved. Using the recommended fasting plasma glucose value of > or = 126 mg/dl for the diagnosis of DM, we would have missed 71.9% of the patients with undiagnosed DM. If all patients with a fasting plasma glucose of > or = 90 mg/dl had been subjected to OGTT, 93.8% of DM would have been identified.


CONCLUSIONS
Prevalences of DM and IGR are higher than expected in patients with CHD. An OGTT should be considered for all patients with a fasting plasma glucose > or = 90 mg/dl undergoing a coronary angiography.
Lankisch
M
M
Deutsche Diabetes-Klinik und Institut für Biometrie und Epidemiologie, German Diabetes Center, Deutsches Diabetes Zentrum an der Heinrich-Heine-Universität Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany.
Füth
R
R
Schotes
D
D
Rose
B
B
Lapp
H
H
Rathmann
W
W
Haastert
B
B
Gülker
H
H
Scherbaum
W A
WA
Martin
Stephan
S
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D033162:Incidental Findings; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012372:ROC Curve
D001786:Blood Glucose