Newly diagnosed type 2 diabetes and prediabetes in hospitalized patients with cardiovascular diseases:prevalence and conformity of baseline blood pressure, lipids and HbA 1c to target levels

Aim

To estimate the prevalence of carbohydrate metabolism disorders and the conformity of baseline blood pressure (BP), low-density lipoproteins (LDL), and HbA 1c to the target levels in patients with established cardiovascular diseases.

Material and methods

773 hospitalized patients with established cardiovascular diseases were enrolled in the single-center prospective observational study (registry). All of them were screened for carbohydrate metabolism disorders using HbA 1c , fasting plasma glucose and, if necessary, an oral glucose tolerance test. Target BP, LDL, and HbA 1c levels were defined by the Russian and international guidelines.

Results

186 patients (24.1%) patients had established type 2 diabetes mellitus (T2DM), and 14 patients (1.8%) had previously diagnosed prediabetes. After screening, newly diagnosed prediabetes was detected in 121 patients (15.7%), and newly diagnosed T2DM was found in 111 patients (14.4%). Baseline BP was at target levels in 33.1% of patients with newly diagnosed prediabetes, 36.0% of patients with newly diagnosed T2DM, and 31.2% of patients with established T2DM versus 67.7% of patients without carbohydrate metabolism disorders (p<0.0001). Baseline LDL was at target levels in 16.5% of patients without carbohydrate metabolism disorders, 8.3% of patients with newly diagnosed prediabetes, 18.9% of patients with newly diagnosed T2DM, and 13.0% of patients with established T2DM. Less than half of patients (45.1%) with newly diagnosed T2DM had target HbA 1c levels, whereas glycemic control was adequate in 64.9% of patients with previously established T2DM (p=0.001). In 97.5% of patients with newly diagnosed prediabetes, baseline BP, and LDL levels did not conform to the targets. In 95.5% and 97.3% of patients with newly diagnosed or established T2DM, respectively, baseline BP, LDL, and HbA 1c did not conform to the targets.

Conclusion

The overall incidence of carbohydrate metabolism disorders among patients with established cardiovascular diseases admitted to an emergency hospital was 55.9%. Patients with carbohydrate metabolism disorders had an unsatisfactory control of BP, LDL, and HbA 1c at the time of hospitalization.

Key words

Newly diagnosed type 2 diabetes mellitus, newly diagnosed prediabetes, target level, blood pressure, LDL, glycated hemoglobin.