Undiagnosed IGT/IFG & Diabetes in Heart Disease and Hypertension
Undiagnosed IGT/IFG & Diabetes in Heart Disease and Hypertension
Diabetes mellitus causes significant morbidity and mortality, and up to 50% of people with diabetes may be as yet undiagnosed. Additionally impaired glucose tolerance (IGT) is known to increase vascular risk and the risk of developing diabetes.
The aim of this study was to look for IGT and/or impaired fasting glucose (IFG) and undiagnosed diabetes amongst patients with hypertension and patients with ischaemic heart disease (IHD) as part of an annual structured assessment.
In IHD patients the uptake was 83.45% with a yield of 2.47% for undiagnosed diabetes and 12.39% for IGT/IFG. In hypertensive patients the uptake was 75.84% with a yield of 2.01% for undiagnosed diabetes and 18.54% for IGT/IFG.
We concluded that looking for undiagnosed type 2 diabetes and patients with IGT/IFG in primary care may be worthwhile amongst patients with hypertension or IHD.
It is estimated that up to 50% of people with diabetes remain undiagnosed and are therefore at increased vascular risk. It is well established that active control of glycaemic status and management of risk factors reduces the incidence and progression of complications. Identifying these people with undiagnosed diabetes is therefore important, particularly if they are diagnosed prior to the development of symptomatic complications. The American Diabetes Association (ADA) has suggested a policy of universal screening for diabetes in general practice of all patients over 45 years old. One year ago we attempted to identify patients in our practice with either ischaemic heart disease (IHD) or hypertension who might have undiagnosed type 2 diabetes. We had to perform blood glucose tests on 24 patients with IHD and 33 with hypertension to identify one new case of type 2 diabetes. This smaller targeted study had both a higher uptake (80% vs. 35.3%) and yield (3% vs. 0.2%) compared to the study by Lawrence et al. of about 2,500 primary care patients aged over 45 years. In our first study we did not screen for impaired glucose tolerance (IGT). Since IGT is associated with an increased risk of IHD and lifestyle interventions are known to be effective in delaying or preventing the progression from IGT to type 2 diabetes, testing for IGT was included in the study. The purpose of this study was two-fold:
To do this we performed a cross-sectional study of our patients with IHD or hypertension.
Diabetes mellitus causes significant morbidity and mortality, and up to 50% of people with diabetes may be as yet undiagnosed. Additionally impaired glucose tolerance (IGT) is known to increase vascular risk and the risk of developing diabetes.
The aim of this study was to look for IGT and/or impaired fasting glucose (IFG) and undiagnosed diabetes amongst patients with hypertension and patients with ischaemic heart disease (IHD) as part of an annual structured assessment.
In IHD patients the uptake was 83.45% with a yield of 2.47% for undiagnosed diabetes and 12.39% for IGT/IFG. In hypertensive patients the uptake was 75.84% with a yield of 2.01% for undiagnosed diabetes and 18.54% for IGT/IFG.
We concluded that looking for undiagnosed type 2 diabetes and patients with IGT/IFG in primary care may be worthwhile amongst patients with hypertension or IHD.
It is estimated that up to 50% of people with diabetes remain undiagnosed and are therefore at increased vascular risk. It is well established that active control of glycaemic status and management of risk factors reduces the incidence and progression of complications. Identifying these people with undiagnosed diabetes is therefore important, particularly if they are diagnosed prior to the development of symptomatic complications. The American Diabetes Association (ADA) has suggested a policy of universal screening for diabetes in general practice of all patients over 45 years old. One year ago we attempted to identify patients in our practice with either ischaemic heart disease (IHD) or hypertension who might have undiagnosed type 2 diabetes. We had to perform blood glucose tests on 24 patients with IHD and 33 with hypertension to identify one new case of type 2 diabetes. This smaller targeted study had both a higher uptake (80% vs. 35.3%) and yield (3% vs. 0.2%) compared to the study by Lawrence et al. of about 2,500 primary care patients aged over 45 years. In our first study we did not screen for impaired glucose tolerance (IGT). Since IGT is associated with an increased risk of IHD and lifestyle interventions are known to be effective in delaying or preventing the progression from IGT to type 2 diabetes, testing for IGT was included in the study. The purpose of this study was two-fold:
|
To do this we performed a cross-sectional study of our patients with IHD or hypertension.
Source...