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Unsuspected Diabetes Common in Heart Patients

Aug 30, 2005

57% of patients who go into the hospital for a heart attack get diagnosed with diabetes or impaired glucose tolerance. Diabetes often goes unrecognized — and therefore untreated — in people who suffer a heart attack or have severe coronary heart disease, according to new research.

Dr. Darcy Green Conaway stated that "the majority of patients" who are seen in emergency rooms with a heart attack or heart-related chest pain "have impaired glucose metabolism," and this represents an opportunity for doctors to intervene. "Only once we recognize what we are missing can we then improve it."

Among 1,199 heart patients who were seen at two hospitals in Kansas City, Missouri, 57 percent had abnormal glucose levels, Conaway and colleagues found.

Of these, 321 (27 percent) had known diabetes. Among the remaining 878 patients, 126 (14 percent) had new-onset diabetes, based on their fasting blood glucose level, the team reports in the American Journal of Cardiology.

However, only 35 percent of the patients with newly detected diabetes were actually told about their condition and treated for diabetes. "The remaining 65 percent were left undiagnosed and, hence, untreated on discharge," the team notes.

"Importantly, we found a substantial number of patients who had high fasting plasma glucose levels," a pre-diabetes sign, but none of these patients received such a diagnosis.

Conaway and colleagues conclude in their report that "one way to ‘catch’ some of these undiagnosed patients" is to use a simple blood glucose test to screen people who go to the hospital because of a heart attack or severe chest pain.
American Journal of Cardiology, August 1, 2005.


Rosiglitazone Lowers Insulin Resistance in Nondiabetics: Rosiglitazone treatment results in an increase in insulin sensitivity in nondiabetic insulin-resistant individuals. This, they suggest, might prevent progression to diabetes. "Insulin-resistant individuals are able to maintain normal glucose tolerance at the expense of compensatory hyperinsulinemia." "The results of this study indicated that rosiglitazone-induced insulin sensitivity was associated with a return towards normal of the glucose-stimulated insulin secretory dose response curve." "By restoring more normal pancreatic beta-cell function," Dr. Reaven concluded, "these findings support the view that the decompensation in beta-cell function that heralds the transition from insulin resistance to frank diabetes could be prevented by such treatment of nondiabetic, insulin resistant persons."
Diabetes 2005;54:2247-2252.




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