Value of testing glycated hemoglobin in non-diabetic patients presenting with acute coronary syndrome

Abstract

Objectives: To estimate the proportion of patients with no previous diagnosis of diabetes admitted with acute coronary syndrome having normal, impaired fasting glucose and diabetes on fasting blood glucose testing and normal, pre-diabetes and diabetes on glycated hemoglobin. To compare the clinical profiles of patients with acute coronary syndrome with no diabetes according to both tests, with those having no diabetes on fasting blood glucose but having diabetes according to glycated hemoglobin.

Methods: In a cross sectional study, fasting blood sugar and glycated hemoglobin were estimated in 125 patients without a previous history of diabetes admitted with acute coronary syndrome. Glycemic category was ascertained according to fasting blood glucose and glycated hemoglobin levels recommended by the American Diabetes Association.

Results: According to glycated hemoglobin testing, 47% and 53% of patients with acute coronary syndrome had diabetes and pre diabetes respectively. The corresponding percentages in each category according to fasting blood glucose testing were six (4%) and twenty (16%). There were no significant differences in the mean age, body mass index or waist circumference of patients in the categories with no diabetes on both testing methods and diabetes only on glycated hemoglobin testing.

Conclusions: According to glycated hemoglobin testing, every patient with acute coronary syndrome has either diabetes or pre diabetes. Compared to fasting blood glucose testing alone, additional testing for glycated hemoglobin in patients with acute coronary syndrome increase the number of patients with newly diagnosed diabetes by eight fold and pre diabetes by two and a half fold.

Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2015; 5: 4-7