Dysglycemia screening suboptimal in patients with CAD

  • Ferrannini G & al.
  • Diabetes Care
  • 20 Feb 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Recommended screening for dysglycemia in people with coronary artery disease (CAD) is suboptiomal in Europe.
  • Achievement of guideline-recommended lifestyle risk factor and pharmacological management is “unacceptably poor.”

Why this matters

  • Approximately two-thirds of coronary patients have impaired glucose tolerance (IGT) or diabetes and are at increased cardiovascular risk.

Study design

  • The European Society of Cardiology’s 27-nation EUROASPIRE V (2016-2017) included 8261 patients with CAD aged 18-80 years.
  • Those with unknown glycemic status underwent oral glucose tolerance test (OGTT) and HbA1c measurement.
  • Funding: Grants from Amgen, Daiichi Sankyo, Eli Lilly, Pfizer, Sanofi, Ferrer, and Novo Nordisk.

Key results

  • Of 4440 who underwent OGTT, 41.08% had IGT, and 16.4% had type 2 diabetes (T2D).
  • Without OGTT, 32.64% of patients with T2D and 69.8% with IGT would not have been detected.
  • Cardioprotective drugs were prescribed to 49% with normoglycemia, 52.9% with newly diagnosed dysglycemia, and 57.8% with previously diagnosed diabetes.
  • Of patients with established diabetes, 57% had been given lifestyle and dietary advice, and 75% were prescribed glucose-lowering agents.
  • Only 30.8% were advised to attend a diabetes educational program, and only 24.1% did so.

Limitations

  • Relatively low participation rate.
  • Potential selection bias of centers.
  • Only a single dysglycemia screening was performed.