Home > Journal Club > Journal Club 20 May 2015

Journal Club 20 May 2015

Paper


Screening for dysglycaemia in patients with coronary artery disease as reflected by fasting glucose, oral glucose tolerance test, and HbA1c: a report fromEUROASPIRE IV—a survey from the European Society of Cardiology

Presenter

Summary

Aims

Three methods are used to identify dysglycaemia: fasting plasma glucose (FPG), 2-h post-load plasma glucose (2hPG)
from the oral glucose tolerance test (OGTT), and glycated haemoglobin A1c (HbA1c). The aim was to describe the
yield and concordance of FPG, HbA1c, and 2hPG alone, or in combination, to identify dysglycaemia in patients with
coronary artery disease.

Methods and results

In EUROASPIRE IV, a cross-sectional survey of patients aged 18–80 years with coronary artery disease in 24 European
countries, 4004 patients with no reported history of diabetes had FPG, 2hPG, and HbA1c measured. All participants
were divided into different glycaemic categories according to the ADA and WHO criteria for dysglycaemia. Using all
screening tests together, 1158 (29%) had undetected diabetes. Out of them, the proportion identified by FPG was
75%, by 2hPG 40%, by HbA1c 17%, by FPG + HbA1c 81%, and byOGTT(¼FPG + 2hPG) 96%. Only 7% were detected
by all three methods FPG, 2hPG, and HbA1c. The ADA criteria (FPG + HbA1c) identified 90% of the population as
having dysglycaemia compared with 73% with the WHO criteria (OGTT ¼ FPG + 2hPG). Screening according to the
ADA criteria for FPG + HbA1c identified 2643 (66%) as having a ‘high risk for diabetes’, while the WHO criteria for
FPG + 2hPG identified 1829 patients (46%).

Conclusion

In patients with established coronary artery disease, the OGTT identifies the largest number of patients with previously
undiagnosed diabetes and should be the preferred test when assessing the glycaemic state of such patients.

Supplementary material

Editorial of the paper
Editorial on diagnosis of diabetes mellitus

Advertisements
Categories: Journal Club Tags:
  1. No comments yet.
  1. No trackbacks yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: