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More than 10% of patients with acute MI may have undiagnosed diabetes

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It is estimated that about 10% of patients with MI may also have undiagnosed diabetes, according to new research presented at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions.

“By recognizing and treating diabetes early, we may be able to prevent additional cardiovascular complications through diet, weight loss and lifestyle changes in addition to taking medications. Another important reason to diagnose diabetes at the time of heart attack is that it can guide the treatments for the patient’s coronary artery disease,” Suzanne V. Arnold, MD, MHA, assistant professor at Saint Luke’s Mid America Heart Institute and the University of Missouri at Kansas City, said in a press release.

Arnold and colleagues studied data on 2,854 patients with acute MI at 24 US hospitals. All patients were unaware of a known diagnosis of diabetes at the time of MI. For this study, diabetes was defined as HbA1c ≥6.5%; if a HbA1c level was missing, diabetes was defined as two or more fasting glucose levels ≥126 mg/dL or one or more fasting glucose level ≥126 mg/dL and glucose at presentation ≥200 mg/dL, according to the study abstract.

In total, 287 (10.1%) of the 2,854 patients with acute MI and no known diabetes on admission had core lab-diagnosed diabetes. Physicians failed to recognize diabetes in 198 (69%) of the previously undiagnosed patients, according to the researchers. They were 17 time more likely to recognize patients’ diabetes if they checked the HbA1c test results during the MI, and even more likely the higher the HbA1c level, according to the press release.

Less than one-third of the 287 patients diagnosed with diabetes received diabetes education or medicine upon discharge. Six months after discharge, less than 7% of patients who were not recognized as having diabetes during their hospital stay after acute MI had started diabetes medication vs. 71% of patients whose diagnosis was confirmed while in the hospital.

For more information:

Arnold SV. Abstract 4. Presented at: American Heart Association Quality of Care and Outcomes Research Scientific Sessions; June 2-4, 2014; Baltimore.

Disclosure: The researchers report no relevant financial disclosures.