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The combination of fasting and admission plasma glucose tests was a useful initial screening tool to identify diabetes in patients with acute coronary syndrome, according to a study of 140 patients admitted to a coronary care unit.
It has been shown that diabetes is underdiagnosed in ACS patients and is a strong predictor of future cardiovascular mortality, Dr. Onyebuchi E. Okosieme of Cardiff (Wales) University and colleagues wrote.
The oral glucose tolerance test (OGTT) is the preferred method for detecting diabetes, but the OGTT is expensive and time consuming, and “is underused in clinical practice,” according to the authors. However, the alternatives—fasting plasma glucose (FPG) and admission plasma glucose (APG)—alone often fail to detect diabetes after a cardiac event.
In this study, each patient (average age 67 years, 79% men) underwent all three methods of testing glucose levels, and were classified as having normal glucose tolerance, impaired glucose tolerance, or diabetes.
According to the results of the OGTT, 27% of this population (38 patients) had previously undiagnosed diabetes, 39% (54 patients) had previously undetected impaired glucose tolerance, and the remainder had normal glucose tolerance. No statistically significant differences were found among the three groups in body mass index, blood pressure, total cholesterol, and triglyceride levels.
When the results of the other testing methods were compared with those of the preferred method, the FPG had 82% sensitivity and 65% specificity in detecting diabetes, whereas the APG had 67% sensitivity and 83% specificity.
When the FPG and APG tests were combined, however, the results were 90% sensitive and 57% specific. Therefore, relying on the two tests in combination would have missed only 10% of diabetic patients and would have limited the need for OGTT testing to 52% of ACS patients, Dr. Okosieme and colleagues wrote (Diabetes Care 2008;31:1955–9).
“The combination of FPG and APG measurements was highly sensitive in identifying patients with diabetes,” they concluded. These measurements “are readily available in the acute setting and could form a useful initial screening tool.”
No conflicts of interest were mentioned.
The combination of fasting and admission plasma glucose tests was a useful initial screening tool to identify diabetes in patients with acute coronary syndrome, according to a study of 140 patients admitted to a coronary care unit.
It has been shown that diabetes is underdiagnosed in ACS patients and is a strong predictor of future cardiovascular mortality, Dr. Onyebuchi E. Okosieme of Cardiff (Wales) University and colleagues wrote.
The oral glucose tolerance test (OGTT) is the preferred method for detecting diabetes, but the OGTT is expensive and time consuming, and “is underused in clinical practice,” according to the authors. However, the alternatives—fasting plasma glucose (FPG) and admission plasma glucose (APG)—alone often fail to detect diabetes after a cardiac event.
In this study, each patient (average age 67 years, 79% men) underwent all three methods of testing glucose levels, and were classified as having normal glucose tolerance, impaired glucose tolerance, or diabetes.
According to the results of the OGTT, 27% of this population (38 patients) had previously undiagnosed diabetes, 39% (54 patients) had previously undetected impaired glucose tolerance, and the remainder had normal glucose tolerance. No statistically significant differences were found among the three groups in body mass index, blood pressure, total cholesterol, and triglyceride levels.
When the results of the other testing methods were compared with those of the preferred method, the FPG had 82% sensitivity and 65% specificity in detecting diabetes, whereas the APG had 67% sensitivity and 83% specificity.
When the FPG and APG tests were combined, however, the results were 90% sensitive and 57% specific. Therefore, relying on the two tests in combination would have missed only 10% of diabetic patients and would have limited the need for OGTT testing to 52% of ACS patients, Dr. Okosieme and colleagues wrote (Diabetes Care 2008;31:1955–9).
“The combination of FPG and APG measurements was highly sensitive in identifying patients with diabetes,” they concluded. These measurements “are readily available in the acute setting and could form a useful initial screening tool.”
No conflicts of interest were mentioned.
The combination of fasting and admission plasma glucose tests was a useful initial screening tool to identify diabetes in patients with acute coronary syndrome, according to a study of 140 patients admitted to a coronary care unit.
It has been shown that diabetes is underdiagnosed in ACS patients and is a strong predictor of future cardiovascular mortality, Dr. Onyebuchi E. Okosieme of Cardiff (Wales) University and colleagues wrote.
The oral glucose tolerance test (OGTT) is the preferred method for detecting diabetes, but the OGTT is expensive and time consuming, and “is underused in clinical practice,” according to the authors. However, the alternatives—fasting plasma glucose (FPG) and admission plasma glucose (APG)—alone often fail to detect diabetes after a cardiac event.
In this study, each patient (average age 67 years, 79% men) underwent all three methods of testing glucose levels, and were classified as having normal glucose tolerance, impaired glucose tolerance, or diabetes.
According to the results of the OGTT, 27% of this population (38 patients) had previously undiagnosed diabetes, 39% (54 patients) had previously undetected impaired glucose tolerance, and the remainder had normal glucose tolerance. No statistically significant differences were found among the three groups in body mass index, blood pressure, total cholesterol, and triglyceride levels.
When the results of the other testing methods were compared with those of the preferred method, the FPG had 82% sensitivity and 65% specificity in detecting diabetes, whereas the APG had 67% sensitivity and 83% specificity.
When the FPG and APG tests were combined, however, the results were 90% sensitive and 57% specific. Therefore, relying on the two tests in combination would have missed only 10% of diabetic patients and would have limited the need for OGTT testing to 52% of ACS patients, Dr. Okosieme and colleagues wrote (Diabetes Care 2008;31:1955–9).
“The combination of FPG and APG measurements was highly sensitive in identifying patients with diabetes,” they concluded. These measurements “are readily available in the acute setting and could form a useful initial screening tool.”
No conflicts of interest were mentioned.