Testing
patients who have had heart attacks for signs of diabetes before they
leave the hospital may identify those with the highest risk of future
heart attacks, researchers report.
Researchers
found that many people hospitalized for a heart attack have
undiagnosed diabetes or prediabetes, a term coined to describe the
millions of overweight and obese people who have blood sugar levels
suggesting an elevated risk of full-blown diabetes.
Because
diabetes increases the risk of death from heart disease, the study
"opens up new possibilities for preventing relapses of (heart
attack) and untimely death,"said lead author Dr. Lars Ryden, of
Karolinska Hospital in Stockholm, Sweden.
Medications,
exercise and diet changes, all of which can restore normal glucose
levels, may reduce the risk of heart attacks in patients who have
already had a heart attack, he said.
Patients
with prediabetes have been shown to be at higher risk of heart
disease, and among people who have a heart attack, those who have
diabetes are more likely to die, the report indicates.
Conditions
that can lead to diabetes often go undetected, however, so the
investigators, under the leadership of Dr. Anna Norhammar, set out to
see how many heart attack patients have blood sugar irregularities
even though they had not been diagnosed with diabetes.
The
testing revealed that a substantial percentage of 181 heart attack
patients in the study had blood sugar abnormalities, the researchers
report in the June 22nd issue of the medical journal The Lancet. At
hospital discharge, 31% of patients were diagnosed with diabetes and
35% with signs of prediabetes. The abnormalities were not temporary: 3
months later, 25% of patients had diabetes and 40% had signs of
prediabetes.
Based
on the results of the study, the authors recommend that heart attack
patients be tested for signs of diabetes before being discharged from
the hospital.
The
percentage of heart attack patients with previously undiagnosed
diabetes or impaired glucose intolerance is higher than expected,
writes Dr. Steven M. Haffner, of the University of Texas Health
Science Center at San Antonio, in an accompanying editorial. The
Lancet 2002;359:2127-2128, 2140-2144.
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