gms | German Medical Science

Background: Almost one in two hypertensive patients (pts) also shows impaired fasting glucose or impaired glucose tolerance (IFG, IGT, "pre-diabetes"), which means their risk for cardiovascular disease is almost as high as for pats with manifest diabetes mellitus. If antihypertensive treatment is optimized early on, the risk for cardio- and cerebrovascular complications can be reduced.

As a result of the diagnostic PraeDiSc study, a score sheet aimed at identifying risk pts at an early stage was developed. This score employs easily determinable parameters to estimate the pt´s risk for pre-diabetes.

Methods: To show if this score sheet is useful in the setting of GP-offices, doctors were asked to screen pts using the score to determine the risk of their hypertensive pts. For the first five pts in each GP-office showing an increased or high risk for pre-diabetes more detailed data with regard to diagnostic measures were documeted. (2h oral glucose tolerance test, fasting or postprandial glucose) It should be investigated if the score classification will correlate with these parameters under office conditions.

Results: 478 general practioners participated. 2268 pts were documented who showed an increased to high risk for pre-diabetes (76,6% increased risk, 23,4% high risk). Mean age of these pats was 60 yrs, mean BMI 31,3 kg/m2. 51,9% were male.

Average values for office bp were 151/89 mmHg, for post prandial glucose 144,4 mg/dl, for fasting glucose 116,0 mg/dl and for OGTT (2h) 161,2 mg/dl.

70% of patients showed pathological 2h OGTT or even diabetes. In the high-risk group 77% showed impaired glucose tolerance or even diabetes. (increased risk group 68%) Further results will be presented.

Conclusion: The PraeDiSc-Risc-Score-sheet is easy to use and able to detect the majority of hypertensive patients with prediabetes.