gms | German Medical Science

Patients with type 2 diabetes mellitus and impaired glucose tolerance are at greater risk of dying from cardiovascular complications. We investigated the prevalence of impaired glucose metabolism in patients admitted for invasive diagnosis with suspected coronary artery disease (CAD) and evaluated the risk factors involved.

Methods: Our study included 506 patients, who were classified according to the guidelines of the German Diabetes Association: DM = known diabetes mellitus (anamnesis, medication), DM new = newly diagnosed diabetes mellitus, IGT = impaired glucose tolerance, IFG = impaired fasting glucose and NGT = normal glucose tolerance. The following parameters were measured: fasting blood glucose, HbA1c, fructosamine, repeated oral glucose tolerance test (oGTT) for fasting and 2-hour values with 75 g glucose, lipid status, highly-sensitive CRP, fibrinogen, hemoglobin, creatinine, urea and albumin excretion.

Results: 130 patients (25.7%) had known diabetes; diabetes was newly diagnosed in 62 patients (12.3%). In 61% the oGTT revealed an impaired glucose metabolism. Patients with DM were significantly older than patients with NGT, had a higher BMI, had significantly lower overall cholesterol, LDL-C. and HDL-C. values, as well as higher triglyceride values, and they were more likely to take statins (61% vs. 50%). Hypertensives were more likely to have an impaired glucose metabolism. Diabetics had significantly higher CRP and fibrinogen values, increased creatinine and urea levels, as well as reduced left-ventricular ejection fraction in the biplanar levocardiogram. There were no significant differences in the IGT, IFG and NTG risk profiles.

Conclusion: Patients with type 2 diabetes mellitus are more likely to suffer from end-organ damage: diabetic nephropathy, CAD and reduced left-ventricular function. They are also more likely to display classic risk factors, such as obesity, arterial hypertension, dyslipoproteinemia and higher CRP and fibrinogen levels.