Undetected dysglycaemia common in primary care patients treated for hypertension and/or dyslipidaemia : on the need for a screening strategy in clinical practice : a report from EUROASPIRE IV a registry from the EuroObservational Research Programme of the European Society of Cardiology

Autor: Viveca Gyberg, David R. Wood, Kornelia Kotseva, Guy De Backer, Dirk De Bacquer, Jaakko Tuomilehto, Oliver Schnell, Bahira Shahim, Lars Rydén
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Blood Glucose
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Dyslipidaemia
endocrine system diseases
Endocrinology
Diabetes and Metabolism
Blood Pressure
Type 2 diabetes
030204 cardiovascular system & hematology
Impaired glucose tolerance
Coronary artery disease
0302 clinical medicine
Risk Factors
Prevalence
Medicine and Health Sciences
CARDIOVASCULAR RISK-FACTORS
Glucose test
Mass Screening
Myocardial infarction
Registries
Original Investigation
Hypolipidemic Agents
INSULIN-RESISTANCE
medicine.diagnostic_test
Middle Aged
Primary care
Lipids
Europe
DENSITY-LIPOPROTEIN CHOLESTEROL
LIFE-STYLE INTERVENTION
Hypertension
Screening
CORONARY-ARTERY-DISEASE
Female
Cardiology and Cardiovascular Medicine
Algorithms
Adult
medicine.medical_specialty
ACUTE MYOCARDIAL-INFARCTION
Adolescent
030209 endocrinology & metabolism
1102 Cardiovascular Medicine And Haematology
FINNISH DIABETES PREVENTION
03 medical and health sciences
Young Adult
Insulin resistance
IMPAIRED GLUCOSE-TOLERANCE
Predictive Value of Tests
Internal medicine
Diabetes mellitus
Glucose Intolerance
medicine
Humans
Hypoglycemic Agents
TERM-FOLLOW-UP
Aged
Dyslipidemias
Glycated Hemoglobin
FINDRISC
business.industry
nutritional and metabolic diseases
Glucose Tolerance Test
medicine.disease
Blood pressure
Cross-Sectional Studies
Diabetes Mellitus
Type 2
Cardiovascular System & Hematology
lcsh:RC666-701
business
Biomarkers
FASTING GLUCOSE
Zdroj: CARDIOVASCULAR DIABETOLOGY
Cardiovascular Diabetology
Cardiovascular Diabetology, Vol 17, Iss 1, Pp 1-11 (2018)
ISSN: 1475-2840
Popis: Background Dysglycaemia defined as type 2 diabetes (T2DM) and impaired glucose tolerance (IGT), increases the risk of cardiovascular disease (CVD). The negative impact is more apparent in the presence of hypertension and/or dyslipidaemia. Thus, it seems reasonable to screen for dysglycaemia in patients treated for hypertension and/or dyslipidaemia. A simple screening algorithm would enhance the adoption of such strategy in clinical practice. Objectives To test the hypotheses (1) that dysglycaemia is common in patients with hypertension and/or dyslipidaemia and (2) that initial screening with the Finnish Diabetes Risk Score (FINDRISC) will decrease the need for laboratory based tests. Methods 2395 patients (age 18–80 years) without (i) a history of CVD or TDM2, (ii) prescribed blood pressure and/or lipid lowering drugs answered the FINDRISC questionnaire and had an oral glucose tolerance test (OGTT) and HbA1c measured. Results According to the OGTT 934 (39%) had previously undetected dysglycaemia (T2DM 19%, IGT 20%). Of patients, who according to FINDRISC had a low, moderate or slightly elevated risk 20, 34 and 41% and of those in the high and very high-risk category 49 and 71% had IGT or T2DM respectively. The OGTT identified 92% of patients with T2DM, FPG + HbA1c 90%, FPG 80%, 2hPG 29% and HbA1c 22%. Conclusions (1) The prevalence of dysglycaemia was high in patients treated for hypertension and/or dyslipidaemia. (2) Due to the high proportion of dysglycaemia in patients with low to moderate FINDRISC risk scores its initial use did not decrease the need for subsequent glucose tests. (3) FPG was the best test for detecting T2DM. Its isolated use is limited by the inability to disclose IGT. A pragmatic strategy, decreasing the demand for an OGTT, would be to screen all patients with FPG followed by OGTT in patients with IFG.
Databáze: OpenAIRE
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