Diabetes Often Went Unrecognized After Heart Attack

Many heart attack patients may have undiagnosed diabetes

(RxWiki News) Diabetes increases risk for heart disease, so a heart attack might be reason to test for diabetes. But it seems a heart attack was not enough for many doctors to take that closer look for diabetes.

A recent study found that doctors often failed to recognize and begin treating diabetes in heart attack patients with no previous history of the disease, even when the patient tested positive for diabetes.

According to the lead author of this study, it's important to diagnose diabetes in people who've had a heart attack. That's because spotting and treating diabetes early can help prevent further heart-related problems.

"Ask your doctor about diabetes testing after a heart attack."

This study was led by Suzanne V. Arnold, MD, assistant professor at Saint Luke’s Mid America Heart Institute and the University of Missouri at Kansas City.

Dr. Arnold and team studied data from 2,854 patients who had a heart attack and had never been diagnosed with type 2 diabetes.

Type 2 diabetes is the most common form of diabetes. People with type 2 diabetes have high blood sugar either from the body not producing enough insulin or their body's inability to respond to the insulin that is produced. Insulin is a hormone produced by the pancreas to help manage blood sugar levels.

The authors of this study found that 10.1 percent or 287 of the heart attack patients tested positive for diabetes using the A1C test during treatment for their heart attack. The A1C test was used to determine their blood sugar levels over the past two to three months.

The research team said that less than one-third of the 287 patients who tested positive for diabetes received education or medication when discharged from the hospital.

The data showed that doctors failed to recognize diabetes in 198 (69 percent) of the 287 patients despite positive A1C testing during their treatment for a heart attack.

The authors noted that when the treating doctors checked the A1C test results while treating for the heart attack, there was a 17-fold greater chance that the diabetes would be diagnosed.

“Diagnosing diabetes in patients who have had a heart attack is important because of the role diabetes plays in heart disease,” Dr. Arnold said in a press release. “By recognizing and treating diabetes early, we may be able to prevent additional cardiovascular complications through diet, weight loss and lifestyle changes in addition to taking medications. Another important reason to diagnose diabetes at the time of heart attack is that it can guide the treatments for the patient’s coronary artery disease.”

The risk of a heart attack is significantly higher for patients with diabetes. According to the authors of this study, two in three patients with diabetes die from heart-related conditions.

The authors concluded that people who have a heart attack should ask for a diabetes test if they have other risk factors like being overweight, high blood pressure or a family history of the disease.

This study was presented June 3 at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2014.

This study was funded by The National Institutes of Health, National Heart, Lung and Blood Institute, and Genentech Inc.

The study's authors made several disclosures of potential competing interests, including with Gilead Sciences, Sanofi Aventis and Genentech.

Review Date: 
June 3, 2014