Copyright © 2001 by the European Society of Cardiology.
Myocardial infarction and prevalence of diabetes mellitus. Is increased casual blood glucose at admission a reliable criterion for the diagnosis of diabetes?
a Department of Medicine, Central Hospital Västerås, Uppsala, Sweden
c Centre for Clinical Research Uppsala University, Central Hospital Västerås, Uppsala, Sweden
b Department of Medicine, University Hospital, Uppsala, Sweden
revised August 31, 2000; accepted September 6, 2000
Abstract
Aims To investigate the prevalence of diabetes mellitus in patients with acute myocardial infarction and to determine whether casual blood glucose and haemoglobin A1c measured at admission could be used to diagnose diabetes mellitus.
Methods and Results A prospective study that included all patients with acute myocardial infarction hospitalized during a one-year period at a coronary care unit. Casual blood glucose was measured at admission, fasting blood glucose during the hospital stay and, if necessary for classification, 2–3 months after discharge. Haemoglobin A1c was measured once at admission. Of 305 patients included in the study, 285 could be classified into three groups: 21% of these had previously diagnosed diabetes, 4% had newly diagnosed diabetes and the remaining patients were categorized as non-diabetic. Casual blood glucose 
11·1mmol.l–1at admission was found in 12 patients with no previously known diabetes, but diabetes mellitus was confirmed in only six of these patients. Haemoglobin A1c showed considerable overlapping of values between the three groups of patients (i.e. patients with known diabetes mellitus, patients with newly diagnosed diabetes mellitus and non-diabetics).
Conclusion One of four patients with acute myocardial infarction had diabetes mellitus. Increased casual blood glucose at admission was not a reliable measure to establish a diagnosis of diabetes and thus follow-up measures were necessary. Haemoglobin A1c was found to be an unreliable measure in the verification of diabetes.
Key Words: Diabetes mellitus, acute myocardial infarction, prevalence, casual blood glucose, stress-induced hyperglycaemia
f1 Correspondence: Dr 
ke Tenerz, Department of Medicine, Central Hospital, S 721 89 Väster
s, Sweden.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R Anantharaman, M Heatley, and C F M Weston Hyperglycaemia in acute coronary syndromes: risk-marker or therapeutic target? Heart, May 1, 2009; 95(9): 697 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Mudespacher, D. Radovanovic, E. Camenzind, M. Essig, O. Bertel, P. Erne, F. R. Eberli, and F. Gutzwiller Admission glycaemia and outcome in patients with acute coronary syndrome Diabetes and Vascular Disease Research, December 1, 2007; 4(4): 346 - 352. [Abstract] [PDF]
|
|
|
|
|
|
C Weston, L Walker, J Birkhead, and National Audit of Myocardial Infarction Project, N Early impact of insulin treatment on mortality for hyperglycaemic patients without known diabetes who present with an acute coronary syndrome Heart, December 1, 2007; 93(12): 1542 - 1546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Dotevall, A. Rosengren, M. Bartnik, K. Malmberg, J. Ohrvik, M. Simoons, L. Ryden, and on behalf of the Euro Heart Survey Investigators Sex-related aspects on abnormal glucose regulation in patients with coronary artery disease Eur. Heart J., February 1, 2007; 28(3): 310 - 315. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ishihara, I. Inoue, T. Kawagoe, Y. Shimatani, S. Kurisu, T. Hata, Y. Nakama, Y. Kijima, and E. Kagawa Is admission hyperglycaemia in non-diabetic patients with acute myocardial infarction a surrogate for previously undiagnosed abnormal glucose tolerance? Eur. Heart J., October 2, 2006; 27(20): 2413 - 2419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Pinto, A. H. Skolnick, A. J. Kirtane, S. A. Murphy, H. V. Barron, R. P. Giugliano, C. P. Cannon, E. Braunwald, C. M. Gibson, and for the TIMI Study Group U-Shaped Relationship of Blood Glucose With Adverse Outcomes Among Patients With ST-Segment Elevation Myocardial Infarction J. Am. Coll. Cardiol., July 5, 2005; 46(1): 178 - 180. [Full Text] [PDF]
|
|
|
|
 |
|
 T. M Conner, K. R Flesner-Gurley, and J. C Barner Hyperglycemia in the Hospital Setting: The Case for Improved Control Among Non-Diabetics Ann. Pharmacother., March 1, 2005; 39(3): 492 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Suleiman, H. Hammerman, M. Boulos, M. R. Kapeliovich, A. Suleiman, Y. Agmon, W. Markiewicz, and D. Aronson Fasting Glucose Is an Important Independent Risk Factor for 30-Day Mortality in Patients With Acute Myocardial Infarction: A Prospective Study Circulation, February 15, 2005; 111(6): 754 - 760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kragelund, O. Snorgaard, L. Kober, B. Bengtsson, M. Ottesen, S. Hojberg, C. Olesen, J.-J. Kjaergaard, J. Carlsen, C. Torp-Petersen, et al. Hyperinsulinaemia is associated with increased long-term mortality following acute myocardial infarction in non-diabetic patients Eur. Heart J., November 1, 2004; 25(21): 1891 - 1897. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Aguilar, S. D. Solomon, L. Kober, J.-L. Rouleau, H. Skali, J. J.V. McMurray, G. S. Francis, M. Henis, C. M. O'Connor, R. Diaz, et al. Newly Diagnosed and Previously Known Diabetes Mellitus and 1-Year Outcomes of Acute Myocardial Infarction: The Valsartan in Acute Myocardial Infarction (VALIANT) Trial Circulation, September 21, 2004; 110(12): 1572 - 1578. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Cely, P. Arora, A. A. Quartin, D. H. Kett, and R. M. H. Schein Relationship of Baseline Glucose Homeostasis to Hyperglycemia During Medical Critical Illness Chest, September 1, 2004; 126(3): 879 - 887. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Stranders, M. Diamant, R. E. van Gelder, H. J. Spruijt, J. W. R. Twisk, R. J. Heine, and F. C. Visser Admission Blood Glucose Level as Risk Indicator of Death After Myocardial Infarction in Patients With and Without Diabetes Mellitus Arch Intern Med, May 10, 2004; 164(9): 982 - 988. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Tenerz, A. Norhammar, A. Silveira, A. Hamsten, G. Nilsson, L. Ryden, and K. Malmberg Diabetes, Insulin Resistance, and the Metabolic Syndrome in Patients With Acute Myocardial Infarction Without Previously Known Diabetes Diabetes Care, October 1, 2003; 26(10): 2770 - 2776. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. N. Wahab, E. A. Cowden, N. J. Pearce, M. J. Gardner, H. Merry, J. L. Cox, and ICONS Investigators Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1748 - 1754. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. M. Montori, B. R. Bistrian, and M. M. McMahon Hyperglycemia in Acutely Ill Patients JAMA, November 6, 2002; 288(17): 2167 - 2169. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Erdmann Cardiovascular events in patients with type 2 diabetes The British Journal of Diabetes & Vascular Disease, January 1, 2002; 2(1_suppl): S4 - S8. [Abstract] [PDF]
|
|
|
|
|
|
I. Gustafsson and P. Hildebrandt Blood glucose in the CCU: time to measure Eur. Heart J., July 1, 2001; 22(13): 1061 - 1062. [PDF]
|
|