Role of oral glucose tolerance test in detection of hyperglycemia among non-diabetic patients with acute myocardial infarction

Previously undetected glucose abnormalities are not unusual in patients with acute myocardial infarction (ami). the aim of the present study is to assess the prevalence of diabetes mellitus (dm) and impaired glucose tolerance (igt) in patients presented with myocardial infarction without known history of dm and to examine whether oral glucose tolerance test (ogtt) is superior to fasting plasma glucose (fpg) and glycosylated hemoglobin (hba1c) as screening tools. we enrolled 112 patients who were admitted to the coronary care unit (ccu) at al-ramadi teaching hospital with acute myocardial infarction and no previous history of diabetes mellitus. an oral glucose tolerance test (ogtt) was done at discharge (mean hospital stay was 5 days). fasting plasma glucose (fpg) and glycosylated hemoglobin (hba1c) were estimated at admission. at discharge,66 patients (58.9%),31(27.7%),and 15(13.4%) were classified as having normal glucose tolerance,impaired glucose tolerance (igt),or type 2 diabetes,respectively. if fasting plasma glucose (fpg) was used alone,only 6 (5.3%) patients were considered diabetic and 8 (7.1%) patients with ifg were identified. hba1c identified only 2 (1.7%) patients with dm and only 4 (3.5%) patients with increased risk of dm. thus,a fpg test alone identified only 30% of the patients with abnormal ogtt. in the present study,a fasting glucose and hba1c test failed to identify more than (70%) and (87%),respectively,of the patients with abnormal glucose tolerance. the prevalence of dm and igt in patients discharged from the ccu after a myocardial infarction without known history dm diagnosis was high (41%). glucose abnormalities were common in patients with ami. in comparison to ogtt,fpg or hba1c alone failed to identify the majority of patients with igt or t2dm screened for undiagnosed glucose abnormalities in patients with mi. the oral glucose tolerance test showed superiority to other means for the screening of glucose intolerance and,thus,should be considered as a routine test after a myocardial infarction in subjects without known dm. © 2017 jordan journal of biological sciences.