Glucometabolic abnormalities survey among outpatients without previous diabetes diagnosis and with coronary artery disease and hypertension / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the status of glucometabolic abnormalities in cardiological outpatients without previous diabetes diagnosis and with coronary artery disease (CAD) and hypertension.</p><p><b>METHODS</b>Patients without previous diagnosis of diabetes but with hypertension and CAD aged 18 years or above were recruited from cardiology departments of 11 general hospitals in China. Demographic data, disease diagnosis and medical history were collected. Physical examination and questionnaire survey were performed after the random blood glucose test. Oral glucose tolerance test (OGTT) examination was made for patients with fasting blood glucose ≥ 6.1 mmol/L or postprandial random glucose ≥ 7.8 mmol/L. Adjusted prevalence rates were used in the study.</p><p><b>RESULTS</b>A total of 7778 patients were included in 11 centers. After preliminary screening by fasting blood glucose and random blood glucose tests, 3861 patients were required to take OGTT, and 3019 (78.2%) patients actually took the test. 1287 out of 3019 patients screened with OGTT were diagnosed with diabetes, and the adjusted diabetes prevalence rate was 18.64% (1287/6904). The prevalence rate of diabetes was 19.87% (95/478), 9.22% (352/3819) and 14.81% (153/1033) in patients with CAD, hypertension, and CAD combined with hypertension, respectively. A total of 996 patients were diagnosed with impaired glucose tolerance (IGT) and its prevalence was 14.43% (996/6904). Of the enrolled population, 153 patients with random blood glucose lower than 7.8 mmol/L were also screened with OGTT test, 26.14% (40/153) patients met the diagnostic criteria of diabetes.</p><p><b>CONCLUSION</b>A high prevalence of diabetes is found in patients without previous diagnosis of diabetes and with hypertension and CAD consulting at cardiology departments. We thus suggest to perform OGTT in this patient cohort to improve the early diagnosis of IGT and diabetes, and prevent missed detection of type 2 diabetes mellitus or IGT in cardiovascular patients with normal fasting blood glucose. Our results indicate that it was feasible to use OGTT as a screening tool for detecting diabetes in these patients and the patient compliance is satisfactory.</p>