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

  1. Märit Wallander, MD1,
  2. Klas Malmberg, MD, PHD1,
  3. Anna Norhammar, MD, PHD1,
  4. Lars Rydén, MD, PHD1 and
  5. Åke Tenerz, MD, PHD2
  1. 1Department of Cardiology, Karolinska University Hospital Solna, Stockholm, Sweden
  2. 2Department of Medicine, Central Hospital, Västerås, Sweden
  1. 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

Abstract

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 κ = 0.35, P < 0.001, and κ = 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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 1 October 2007. DOI: 10.2337/dc07-1552.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted September 27, 2007.
    • Received August 7, 2007.
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  1. Published online before print October 1, 2007, doi: 10.2337/dc07-1552 Diabetes Care January 2008 vol. 31 no. 1 36-38
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