Prevalence of Type 2 diabetes in patients admitted with acute coronary syndrome: the role of easily reproducible non-invasive screening methods

Karamat, Muhammad Ali (2014). Prevalence of Type 2 diabetes in patients admitted with acute coronary syndrome: the role of easily reproducible non-invasive screening methods. University of Birmingham. M.D.

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Abstract

Background:
Diabetes mellitus is a major risk factor for cardiovascular disease and mortality. There is increasing recognition of need to assess glucose tolerance in all patients with cardiovascular disease but less agreement about the most appropriate screening methodology.

Aims:
1. To determine prevalence of undiagnosed diabetes mellitus and impaired glycaemic state (IGS) and compare WHO 1998 and IEC criteria for diagnosis of T2DM in patients with acute coronary syndrome (ACS).
2. To investigate role of screening algorithm including fasting plasma glucose (<7.0 mmol/l) and HbA1c (>6.0%) to accurately define glucose tolerance in patients admitted with ACS.

Methods:
A prospective 3 year study carried out in two large inner city hospitals in UK.

Results:
Patients (n=118) were included. Prevalence of diabetes mellitus was 20% and 16% respectively according to W.H.O and IEC criteria at baseline. The prevalence of T2DM remained similar at 3 months at 21%. However two thirds with IGS and a third with DM changed their glycaemic status at 3 months. We also designed diabetes predictor score based on age, fasting plasma glucose and HbA1c and it had excellent sensitivity >80% and negative predictive value of >90%.

Conclusion:
The W.H.O and IEC diagnostic criteria identify different populations with diabetes at baseline as well as 3 months. This is clinically relevant as we are basing screening in a high risk population on these criteria.

Type of Work:

Thesis (Higher Doctorates > M.D.)

Award Type:

Higher Doctorates > M.D.

Supervisor(s):