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01.11.2011 | Article

Oral glucose tolerance test and HbA_1c for diagnosis of diabetes in patients undergoing coronary angiography the Silent Diabetes Study

verfasst von: R. Doerr, U. Hoffmann, W. Otter, L. Heinemann, W. Hunger-Battefeld, B. Kulzer, A. Klinge, V. Lodwig, I. Amann-Zalan, D. Sturm, D. Tschoepe, S. G. Spitzer, J. Stumpf, T. Lohmann, O. Schnell

Erschienen in: Diabetologia | Ausgabe 11/2011

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Abstract

Aims/hypothesis

The primary aim of this study was to compare the results of HbA_1c measurements with those of an OGTT for early diagnosis of ‘silent diabetes’ in patients with coronary artery disease (CAD) undergoing angiography without prediagnosed diabetes. A secondary aim was to investigate the correlation between the extent of CAD and the glycaemic status of the patient.

Methods

Data from 1,015 patients admitted for acute (n = 149) or elective (n = 866) coronary angiography were analysed. Patients with known diabetes were excluded from the study. Using the OGTT results, patients were classified as having normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or diabetes. According to the results of the HbA_1c measurements, patients were classified into three groups: normal (HbA_1c <5.7% [<39 mmol/mol]), borderline (HbA_1c 5.7–6.4% [39–47 mmol/mol]) and diabetes (HbA_1c ≥6.5% [≥48 mmol/mol]).

Results

Based on the OGTT, 513 patients (51%) were classified with NGT, 10 (1%) with IFG, 349 (34%) with IGT and 149 (14%) were diagnosed with diabetes. According to HbA_1c measurements, 588 patients (58%) were classified as normal, 385 (38%) as borderline and 42 (4%) were diagnosed with diabetes. The proportion of patients with IGT and diabetes increased with the extent of CAD (IGT ρ = 0.14, p < 0.001, diabetes ρ = 0.09, p = 0.01). No differences in HbA_1c were seen among the groups with different extents of CAD (p = 0.652).

Conclusions/interpretation

An OGTT should be performed routinely for diagnosis of diabetes in patients with CAD undergoing coronary angiography, since HbA_1c measurement alone appears to miss a substantial proportion of patients with silent diabetes. A limitation of the study is that the OGTT was not performed before the angiography.

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Titel: Oral glucose tolerance test and HbA1c for diagnosis of diabetes in patients undergoing coronary angiography the Silent Diabetes Study
verfasst von: R. Doerr
U. Hoffmann
W. Otter
L. Heinemann
W. Hunger-Battefeld
B. Kulzer
A. Klinge
V. Lodwig
I. Amann-Zalan
D. Sturm
D. Tschoepe
S. G. Spitzer
J. Stumpf
T. Lohmann
O. Schnell
Publikationsdatum: 01.11.2011
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 11/2011
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-011-2253-y

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Oral glucose tolerance test and HbA_1c for diagnosis of diabetes in patients undergoing coronary angiography the Silent Diabetes Study