Prevalence of cardiovascular disease and risk biomarkers in patients with unknown type 2 diabetes visiting cardiology specialists : results from the DIASPORA study : review

Background : Patients with diabetes mellitus and IGT have a high risk for cardiovascular events. It is tempting to speculate that these patients are often first seen by cardiologists. Design : This cross-sectional study investigates the diabetes prevalence in cardiology care units and the correlated metabolic conditions as assessed by several circulating biomarkers. Methods : Patients aged 55 or older with suspected or overt coronary heart disease were eligible for trial participation. Fasting blood samples were drawn from patients to determine HOMA score, glycaemic and lipid profile, and several risk biomarkers. An OGTT was performed in patients without known diabetes. Results : We enrolled 530 patients (181 male, 349 female, mean age, 68 ± 7 years) in this study from 22 German cardiology centres; 156 patients (29. 4%) had known diabetes and OGTT revealed that 184 patients (34.7%) had no diabetes, 106 patients (20. 0%) had IGT or IFG and 84 patients (15. 9%) were newly diagnosed with diabetes. Increased cardiovascular risk as reflected by increased hsCRP, ICAM and MMP-9 values was observed in diabetes patients. A higher cardiovascular biomarker risk profile was seen in the IGT/IFG cohort. Conclusions : This study confirms the observation that one-third of patients in a cardiology care unit suffer from impaired glucose regulation. Furthermore,the cardiology patients with previously unknown glucose homeostasis abnormalities had a higher prevalence of macrovacular disease and an impaired biomarker risk profile. This study underlines the importance of joint treatment efforts by cardiologists in concert with diabetologists for treatment of this patient group at high risk for cardiovascular events.