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Published online October 1, 2007
Diabetes Care 31:36-38, 2008
DOI: 10.2337/dc07-1552
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Oral Glucose Tolerance Test: A Reliable Tool for Early Detection of Glucose Abnormalities in Patients With Acute Myocardial Infarction in Clinical Practice

A report on repeated oral glucose tolerance tests from the GAMI Study

Märit Wallander, MD1, Klas Malmberg, MD, PHD1, Anna Norhammar, MD, PHD1, Lars Rydén, MD, PHD1 and Åke Tenerz, MD, PHD2

1 Department of Cardiology, Karolinska University Hospital Solna, Stockholm, Sweden
2 Department of Medicine, Central Hospital, Västerås, Sweden

Address correspondence and reprint requests to Märit Wallander, MD, Department of Cardiology, FoU N5:00, Karolinska University, Hospital Solna, 171 76 Stockholm, Sweden. E-mail: marit.wallander{at}ki.se

OBJECTIVE—Previously undetected glucose abnormalities are common in patients with acute myocardial infarction (AMI). We evaluated long-term reliability of early glucometabolic classification of patients with AMI by repeated oral glucose tolerance tests (OGTTs).

RESEARCH DESIGN AND METHODS—A glucometabolic OGTT-based classification was obtained in 122 patients by measuring capillary whole-blood glucose. The classification was performed on three occasions, before hospital discharge and 3 and 12 months thereafter.

RESULTS—At discharge, 34, 31, and 34% were classified as having normal glucose tolerance, impaired glucose tolerance (IGT), or type 2 diabetes, respectively, and 93% of all patients with type 2 diabetes were still classified with type 2 diabetes (n = 27) or IGT (n = 12) after 12 months. The agreements between the OGTTs at discharge and 3 and 12 months were {kappa} = 0.35, P < 0.001, and {kappa} = 0.43, P < 0.001, respectively.

CONCLUSIONS—The outcome of an OGTT performed in AMI patients at hospital discharge reliably informs on long-term glucometabolic state.

Abbreviations: ADA, American Diabetes Association • AMI, acute myocardial infarction • EASD, European Association for the Study of Diabetes • ESC, European Society of Cardiology • GAMI, Glucose tolerance in Acute Myocardial Infarction • HOMA-IR, homeostasis model assessment of insulin resistance • IGI, insulinogenic index • IGT, impaired glucose tolerance • NGT, normal glucose tolerance • OGTT, oral glucose tolerance test • WHO, World Health Organization


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