Prospective evaluation of glucose metabolism in patients undergoing coronary artery bypass grafting.
BACKGROUND
Disturbances of glucose metabolism are associated with increased risk of ischaemic heart disease (IHD). It is not uncommon that IHD and its complications precede diagnosis of glucose metabolism disturbances. Since publication of the American Diabetes Association's 2004 Guidelines for the assessment of glucose metabolism, no prospective evaluation of prevalence of carbohydrate metabolism disorders in patients referred for coronary artery bypass grafting (CABG) has been performed.


OBJECTIVE
Evaluation of prevalence of glucose balance disturbances in consecutive patients with stable IHD who underwent elective CABG procedures.


METHODS
Prospective analysis of glucose metabolism was carried out on a group of 117 consecutive IHD patients (including 31 women) aged below 80 years, selected for elective CABG surgery. In all patients, history assessment and physical examination as well as basic biochemical studies and resting echocardiography were performed. Additionally, in all individuals without previous diagnosis of diabetes mellitus, oral glucose tolerance test (OGTT) was carried out.


RESULTS
History analysis revealed glucose balance disturbances in 35 (29.9%) patients, including diabetes mellitus in 33 (28.2%) subjects and impaired glucose tolerance in 2 (1.7%) individuals. Based on OGTT results, among the remaining 82 (70.1%) subjects without previously known glucose metabolism disturbances 4 (3.4%) patients had abnormal fasting glycaemia, 32 (27.4%) subjects had impaired glucose tolerance, and diabetes mellitus was diagnosed in 12 (10.3%) individuals. No impaired glucose balance was found in only 34 (29.1%) examined subjects.


CONCLUSIONS
Over 70% of all patients undergoing elective CABG procedure presented various forms of carbohydrate metabolism disturbances that were not diagnosed previously. Thus, it seems that the assessment of glucose regulation should be mandatory in all patients undergoing elective CABG surgery.
Greberski
Krzysztof
K
Oddział Kardiochirurgii, Szpital im. J. Strusia, ul. Szkolna 8/12, 61-833 Poznań. kgreberski@poczta.onet.pl
Guzik
Przemysław
P
Wysocki
Henryk
H
Kalawski
Ryszard
R
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D044882:Glucose Metabolism Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies
D001786:Blood Glucose; D006442:Glycated Hemoglobin