title: Seven-year mortality in heart failure patients with undiagnosed diabetes: an observational study.
abstract: BACKGROUND
  Patients with type 2 diabetes mellitus and heart failure have adverse clinical outcomes, but the characteristics and prognosis of those with undiagnosed diabetes in this setting has not been established.
  
  
  METHODS
  In total, 400 patients admitted consecutively with acute heart failure were grouped in three glycaemic categories: no diabetes, clinical diabetes (previously reported or with hypoglycaemic treatment) and undiagnosed diabetes. The latter was defined by the presence of at least two measurements of fasting plasma glycaemia ≥ 7 mmol/L before or after the acute episode.Group differences were tested by proportional hazards models in all-cause and cardiovascular mortality during a 7-year follow-up.
  
  
  RESULTS
  There were 188 (47%) patients without diabetes, 149 (37%) with clinical diabetes and 63 (16%) with undiagnosed diabetes. Patients with undiagnosed diabetes had a lower prevalence of hypertension, dyslipidaemia, peripheral vascular disease and previous myocardial infarction than those with clinical diabetes and similar to that of those without diabetes. The adjusted hazards ratios for 7-year total and cardiovascular mortality compared with the group of subjects without diabetes were 1.69 (95% CI: 1.17-2.46) and 2.45 (95% CI: 1.58-3.81) for those with undiagnosed diabetes, and 1.48 (95% CI: 1.10-1.99) and 2.01 (95% CI: 1.40-2.89) for those with clinical diabetes.
  
  
  CONCLUSIONS
  Undiagnosed diabetes is common in patients requiring hospitalization for acute heart failure. Patients with undiagnosed diabetes, despite having a lower cardiovascular risk profile than those with clinical diabetes, show a similar increased mortality.
authors.affiliation: Department of Endocrinology, Hospital del Mar, Departament de Medicina, Universitat Autónoma de Barcelona, Spain. juanaflores@yahoo.com
authors.forename: Juana A
authors.initials: JA
authors.lastname: Flores-Le Roux
authors.forename: Josep
authors.initials: J
authors.lastname: Comin
authors.forename: Juan
authors.initials: J
authors.lastname: Pedro-Botet
authors.forename: David
authors.initials: D
authors.lastname: Benaiges
authors.forename: Jaume
authors.initials: J
authors.lastname: Puig-de Dou
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Chillarón
authors.forename: Alberto
authors.initials: A
authors.lastname: Goday
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruguera
authors.forename: Juan F
authors.initials: JF
authors.lastname: Cano-Perez
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D001786:Blood Glucose