Patients with Undiagnosed Diabetes Have Worse Short-Term Cardiac Outcomes

Patients who are unaware that they have diabetes may have less contact with healthcare professionals, receive less aggressive treatment, or have a poorer understanding of the disease and the actions required to treat it - all of which may be responsible for their increased risk of morbidity and mortality.

In addition to the 18 million Americans who have diabetes, 35 percent of the population is prediabetic and 7 million Americans have undiagnosed diabetes. Elevated glucose levels at hospital admission and delayed diabetes diagnosis are both associated with worse long-term outcomes for patients. Patients who are unaware that they have diabetes may have less contact with healthcare professionals, receive less aggressive treatment, or have a poorer understanding of the disease and the actions required to treat it — all of which may be responsible for their increased risk of morbidity and mortality.

In a recent study published in the American Heart Journal, a group of international researchers examined the outcomes of 8,795 high-risk, non—ST-segment elevation (NSTE) patients enrolled in an acute coronary syndrome (ACS) trial for prediabetes, previously undiagnosed diabetes, or diabetes. The authors found that 12 percent of the patient population had undiagnosed diabetes and 11 percent had prediabetes.

Thirty days after ACS, the undiagnosed diabetics had increased rates of all-cause death or myocardial infarction. However, at the one year mark, mortality was not elevated in that patient group, and the event rates for prediabetics were similar to those of non-diabetic patients at 30 days and 12 months.

In light of the poor short-term outcomes among the undiagnosed diabetics, the authors recommended increased routine screening for diabetes in order to implement management strategies early.