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Diabetes, Insulin Resistance, and the Metabolic Syndrome in Patients With Acute Myocardial Infarction Without Previously Known Diabetes
Open accessAbstract
OBJECTIVE—Individuals with diabetes have an increased morbidity from acute myocardial infarction (AMI). Based on an oral glucose tolerance test (OGTT), 40–45% of patients with AMI have diabetes. The objective of this study was to characterize the glucometabolic profile of patients with AMI without known diabetes and to see if sustained glucometabolic perturbations are predictable during the hospital phase of the disease. RESEARCH DESIGN AND METHODS—A total of 145 patients with AMI and no previous diagnosis of diabetes were subjected to an OGTT at hospital discharge and 3 months thereafter. Based on the OGTT after 3 months, they were defined as having normal glucose tolerance (NGT; n = 50), impaired glucose tolerance (IGT; n = 59), or diabetes (n = 36). Components of the metabolic syndrome, including insulin resistance assessed by homeostasis model assessment (HOMA-IR), were recorded. RESULTS—Patients with AMI had no changes in insulin resistance from hospital discharge to follow-up. An OGTT and/or a single blood glucose taken 60 min (BG-60) after ingestion of 75 g glucose at hospital discharge were predictors of the outcome of the OGTT at follow-up. With a cutoff value for BG-60 of 8.6 mmol/l, 70% of the patients were correctly predicted as either belonging to the NGT group or the IGT/diabetes group after 3 months. Age, BMI, antihypertensive treatment, HbA1c, fasting blood glucose, blood lipids, insulin, proinsulin, HOMA-IR, and plasminogen activator inhibitor 1 did not add predictive power. CONCLUSIONS—Patients with AMI and no previous diagnosis of diabetes have no changes in insulin resistance from hospital discharge to a 3-month follow-up. An OGTT or a single BG-60 performed at hospital discharge predicts the diagnosis of IGT or diabetes 3 months thereafter.
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“a recent study has suggested that most patients who have DM that is newly diagnosed during hospitalization for ACS continue to have increased glucose levels after 3 months.5”
From Frequency of undiagnosed diabetes mellitus in patients with acute coronary syndrome (2005) · cites this paper as [5]
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“Patients who have DM or the metabolic syndrome are at markedly higher risk for recurrent cardiovascular events after ACS. 5”
From Frequency of undiagnosed diabetes mellitus in patients with acute coronary syndrome (2005) · cites this paper as [5]
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Metadata
- Authors
- Tenerz, A., Norhammar, A., Silveira, A., Hamsten, A., Nilsson, G., Rydén, L., & Malmberg, K.
- Affiliations
- Department of Medicine, Central Hospital, Västerås, Sweden
- Karolinska University Hospital (SE)
- Department of Cardiology, Karolinska Hospital, Stockholm, Sweden
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2003-10-01
- Volume
- 26
- Issue
- 10
- Pages
- 2770-2776
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2154789499
- Cited by
- 139
- References
- 27
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 6 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 14 · 2013: 8 · 2012: 7
- FWCI
- 8.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Vetenskapsrådet
- Landstinget Västmanland
- Johnson and Johnson
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- acute myocardial infarction, insulin resistance, metabolic syndrome, impaired glucose tolerance, diabetes diagnosis, oral glucose tolerance test, HOMA-IR, hospital discharge
- MeSH terms
- Acute Disease, Adult, Blood Glucose, Diabetes Mellitus, Type 2, Fasting, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Insulin Resistance, Male, Middle Aged, Myocardial Infarction, Predictive Value of Tests, Prevalence, Glucose Intolerance, Metabolic Syndrome
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