Diabetes goes undiagnosed in many acute myocardial infarction patients
Unrecognized diabetes common in acute myocardial infarction patients
HealthDay News — One in 10 acute myocardial infarction patients without a previous diagnosis of diabetes have underlying diabetes, according to research published in Circulation: Cardiovascular Quality and Outcomes.
Suzanne V. Arnold, MD, MHA, from Saint Luke's Mid America Heart Institute in Kansas City, Missouri, and colleagues reported on the incidence of new diabetes and its recognition among patients with acute myocardial infarction (MI).
Data were included for patients in a 24-site United States acute MI registry from 2005 to 2008.
The researchers found that 10% of the 2,854 AMI patients without known diabetes on admission met criteria for previously unknown diabetes, defined by a core laboratory glycosylated hemoglobin of ≥6.5%. Sixty-five percent of these cases were unrecognized by treating clinicians, and had not received diabetes education, glucose-lowering medications at discharge or documentation of diabetes in the chart.
At 6 months after discharge, initiation on glucose-lowering medications occurred in 5% of those not recognized as having diabetes during hospitalization, compared with 66% of those recognized as having diabetes (P<.001).
"Underlying [diabetes mellitus] that has not been previously diagnosed is common among [acute MI] patients, affecting one in 10 patients, yet is recognized by the care team only one-third of the time," the researchers wrote.
"Given its frequency and therapeutic implications, including but extending beyond the initiation of glucose-lowering treatment, consideration should be given to screening all [acute MI] patients for [diabetes mellitus] during hospitalization."
Several authors disclosed financial ties to the pharmaceutical and health care industries.