scholarly journals Postload glucose spike but not fasting glucose determines prognosis after myocardial infarction in patients without known or newly diagnosed diabetes

2021 ◽  
Vol 13 (3) ◽  
pp. 191-199
Author(s):  
Sudipta Chattopadhyay ◽  
Anish George ◽  
Joseph John ◽  
Thozhukat Sathyapalan
Keyword(s):  
Myocardial Infarction ◽  
Fasting Glucose ◽  
Newly Diagnosed ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

scholarly journals Impact of elevated HbA1c on long-term mortality in patients presenting with acute myocardial infarction in daily clinical practice: insights from a ‘real world’ prospective registry of the Zwolle Myocardial Infarction Study Group

2019 ◽  
Vol 9 (6) ◽  
pp. 616-625 ◽  
Author(s):  
Renicus S Hermanides ◽  
Mark W Kennedy ◽  
Elvin Kedhi ◽  
Peter R van Dijk ◽  
Jorik R Timmer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Outcome ◽  
Newly Diagnosed ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
Long Term Mortality ◽  
Diabetes Patients

Background: Long-term clinical outcome is less well known in up to presentation persons unknown with diabetes mellitus who present with acute myocardial infarction and elevated glycosylated haemoglobin (HbA1c) levels on admission. We aimed to study the prognostic impact of deranged HbA1c at presentation on long-term mortality in patients not known with diabetes, presenting with acute myocardial infarction. Methods: A single-centre, large, prospective observational study in patients with and without known diabetes admitted to our hospital for ST-segment elevation myocardial infarction (STEMI) and non-STEMI. Newly diagnosed diabetes mellitus was defined as HbA1c of 48 mmol/l or greater and pre-diabetes mellitus was defined as HbA1c between 39 and 47 mmol/l. The primary endpoint was all-cause mortality at short (30 days) and long-term (median 52 months) follow-up. Results: Out of 7900 acute myocardial infarction patients studied, 1314 patients (17%) were known diabetes patients. Of the 6586 patients without known diabetes, 3977 (60%) had no diabetes, 2259 (34%) had pre-diabetes and 350 (5%) had newly diagnosed diabetes based on HbA1c on admission. Both short-term (3.9% vs. 7.4% vs. 6.0%, p<0.001) and long-term mortality (19% vs. 26% vs. 35%, p<0.001) for both pre-diabetes patients as well as newly diagnosed diabetes patients was poor and comparable to known diabetes patients. After multivariate analysis, newly diagnosed diabetes was independently associated with long-term mortality (hazard ratio 1.72, 95% confidence interval 1.27–2.34, P=0.001). Conclusions: In the largest study to date, newly diagnosed or pre-diabetes was present in 33% of acute myocardial infarction patients and was associated with poor long-term clinical outcome. Newly diagnosed diabetes (HbA1c ⩾48 mmol/mol) is an independent predictor of long-term mortality. More attention to early detection of diabetic status and initiation of blood glucose-lowering treatment is necessary.

scholarly journals Increased Arterial Stiffness in Prediabetic Subjects Recognized by Hemoglobin A1c with Postprandial Glucose but Not Fasting Glucose Levels

2019 ◽  
Vol 8 (5) ◽  
pp. 603
Author(s):  
Chung-Hao Li ◽  
Feng-Hwa Lu ◽  
Yi-Ching Yang ◽  
Jin-Shang Wu ◽  
Chih-Jen Chang
Keyword(s):  
Arterial Stiffness ◽  
Hemoglobin A1c ◽  
Pulse Wave ◽  
Glycated Hemoglobin ◽  
Fasting Glucose ◽  
Postprandial Glucose ◽  
Newly Diagnosed ◽  
Glucose Levels ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

Previous studies exploring the association between arterial stiffness and prediabetes remain controversial. This study aimed to investigate the association of the different domains of prediabetes categorized by glycated hemoglobin A1c (A1c) 5.7–6.4%, impaired fasting glucose (IFG), fasting plasma glucose of 5.6–6.9 mmol/L, and impaired glucose tolerance (IGT), two-hour post-load glucose of 7.8–11.0 mmol/L, on arterial stiffness. These were measured by brachial–ankle pulse-wave velocity (baPWV). We enrolled 4938 eligible subjects and divided them into the following nine groups: (1) normoglycemic; (2) isolated A1c 5.7–6.4%; (3) isolated IFG; (4) IFG with A1c 5.7–6.4%; (5) isolated IGT; (6) combined IGT and IFG with A1c <5.7%; (7) IGT with A1c 5.7–6.4%; (8) combined IGT and IFG with A1c 5.7–6.4%; and (9) newly diagnosed diabetes (NDD). The baPWV values were significantly high in subjects with NDD (β = 47.69, 95% confidence interval (CI) = 29.02–66.37, p < 0.001), those with IGT with A1c 5.7–6.4% (β = 36.02, 95% CI = 19.08–52.95, p < 0.001), and those with combined IGT and IFG with A1c 5.7–6.4% (β = 27.72, 95% CI = 0.68–54.76, p = 0.044), but not in the other subgroups. These findings suggest that increased arterial stiffness was found in prediabetes individuals having an A1c 5.7–6.4% with IGT, but not IFG. Isolated A1c 5.7–6.4% and isolated IGT were not associated with elevated arterial stiffness.

scholarly journals No evidence of long-term disruption of glycometabolic control after SARS-CoV-2 infection

2021 ◽  
Author(s):  
Andrea Laurenzi ◽  
Amelia Caretto ◽  
Chiara Molinari ◽  
Alessia Mercalli ◽  
Raffaella Melzi ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Public Health Problem ◽  
Newly Diagnosed ◽  
Markers Of Inflammation ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

Abstract Purpose To assess whether dysglycaemia diagnosed during SARS-CoV-2 pneumonia may become a potential public health problem after resolution of the infection. In an adult cohort with suspected COVID-19 pneumonia, we integrated glucose data upon hospital admission with fasting blood glucose (FBG) in the year prior to COVID-19 and during post-discharge follow-up. Methods From February 25th to May 15th 2020 660 adults with suspected COVID-19 pneumonia were admitted to the San Raffaele Hospital (Milan, Italy). Through structured interviews / medical record reviews we collected demographics, clinical features and laboratory tests upon admission and additional data during hospitalization or after discharge and in the previous year. Upon admission, we classified participants according to ADA criteria as having: a) pre-existing diabetes; b) newly diagnosed diabetes; c) hyperglycaemia not in the diabetes range; d) normoglycaemia. FBG prior to admission and during follow-up were classified as normal or impaired fasting glucose and fasting glucose in the diabetes range. Results In patients with confirmed COVID (n=589) the proportion with pre-existing or newly diagnosed diabetes, hyperglycaemia not in the diabetes range and normoglycaemia was 19.6%, 6.7%, 43.7% and 30.0%, respectively. Patients with dysglycaemia associated to COVID-19 had increased markers of inflammation and organs’ injury and poorer clinical outcome compared to those with normoglycemia. After the infection resolved, the prevalence of dysglycaemia reverted to pre-admission frequency. Conclusions COVID-19 associated dysglycaemia is unlikely to become a lasting public health problem. Alarmist claims on the diabetes risk after COVID-19 pneumonia should be interpreted with caution.

Sign in / Sign up

Export Citation Format

Share Document