Glucose homeostasis abnormalities in cardiac intensive care unit patients.
The aim of this study was to characterize the abnormalities in glucose homeostasis in intensive care unit patients following an acute coronary event. The study population included all non-diabetic patients ages 20-80 years that were admitted to a coronary intensive unit. Glucose, insulin and C-peptide levels during an oral glucose tolerance test (OGTT) were measured during the acute admission. From January to September 2003, 277 patients were admitted to the coronary unit. Of these, 127 patients underwent an OGTT. Of these, only 29 patients (23%) exhibited normal glucose metabolism. The remainder had type 2 diabetes (32%), impaired glucose tolerance (37%) or isolated impaired fasting glucose (8%, 100-125 mg/dl). Based on homeostasis model assessment (HOMA) calculations, diabetic patients had impaired beta-cell function and patients with elevated fasting glucose levels were insulin resistant. Beta-cell dysfunction during the acute stress seems to contribute to the glucose abnormalities. Most patients who experience an acute coronary event demonstrate abnormal glucose metabolism. Post glucose-load abnormalities are more common than abnormal fasting glucose level in this situation. It is postulated that the acute stress of a coronary event may contribute to the dysglycemia.
Ilany
Jacob
J
Institute of Endocrinology, Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel. jacob.ilani@sheba.health.gov.il
Marai
Ibrahim
I
Cohen
Ohad
O
Matetzky
Shlomi
S
Gorfine
Malka
M
Erez
Idit
I
Hod
Hanoch
H
Karasik
Avraham
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000378:metabolism; D003325:Coronary Care Units; D005260:Female; D005947:Glucose / Q000378:metabolism; D044882:Glucose Metabolism Disorders / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D055815:Young Adult
D001786:Blood Glucose; D002096:C-Peptide; D005947:Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human