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Oral Glucose Tolerance Test: A Reliable Tool for Early Detection of Glucose Abnormalities in Patients With Acute Myocardial Infarction in Clinical Practice

A report on repeated oral glucose tolerance tests from the GAMI Study

¹ Department of Cardiology, Karolinska University Hospital Solna, Stockholm, Sweden
² Department of Medicine, Central Hospital, Västerås, Sweden

Address correspondence and reprint requests to Märit Wallander, MD, Department of Cardiology, FoU N5:00, Karolinska University, Hospital Solna, 171 76 Stockholm, Sweden. E-mail: marit.wallander{at}ki.se

OBJECTIVE—Previously undetected glucose abnormalities are common in patients with acute myocardial infarction (AMI). We evaluated long-term reliability of early glucometabolic classification of patients with AMI by repeated oral glucose tolerance tests (OGTTs).

RESEARCH DESIGN AND METHODS—A glucometabolic OGTT-based classification was obtained in 122 patients by measuring capillary whole-blood glucose. The classification was performed on three occasions, before hospital discharge and 3 and 12 months thereafter.

RESULTS—At discharge, 34, 31, and 34% were classified as having normal glucose tolerance, impaired glucose tolerance (IGT), or type 2 diabetes, respectively, and 93% of all patients with type 2 diabetes were still classified with type 2 diabetes (n = 27) or IGT (n = 12) after 12 months. The agreements between the OGTTs at discharge and 3 and 12 months were = 0.35, P < 0.001, and = 0.43, P < 0.001, respectively.

CONCLUSIONS—The outcome of an OGTT performed in AMI patients at hospital discharge reliably informs on long-term glucometabolic state.

Abbreviations: ADA, American Diabetes Association • AMI, acute myocardial infarction • EASD, European Association for the Study of Diabetes • ESC, European Society of Cardiology • GAMI, Glucose tolerance in Acute Myocardial Infarction • HOMA-IR, homeostasis model assessment of insulin resistance • IGI, insulinogenic index • IGT, impaired glucose tolerance • NGT, normal glucose tolerance • OGTT, oral glucose tolerance test • WHO, World Health Organization

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