New research suggests that people who arrive at hospital emergency departments with acute heart failure should have their blood sugar levels checked on arrival. This simple and inexpensive measure could identify patients at high risk of early death, further hospitalisations, or the development of more health problems, such as diabetes.
Results of a large study published online in the European Heart Journal, show that even if someone arrives at hospital with no prior diagnosis of diabetes and with blood sugar levels within a range that could be considered as ‘normal’, if their levels are above 6.1 mmol/L they are at higher risk of developing diabetes and early death.
Researchers from the Institute for Clinical Evaluative Sciences (ICES), the Peter Munk Cardiac Centre at the University Health Network, and the University of Toronto, Canada, analysed the outcomes for 16,524 people who arrived at hospital emergency departments in Ontario, Canada, with acute heart failure between 2004 and 2007. The patients were aged between 70-85 years old and 56% (9,275) of them did not have pre-existing diabetes. The researchers compared the outcomes of the patients against a reference group of patients whose blood glucose levels ranged between 3.96.1 mmol/L.
They found that patients without pre-existing diabetes had a risk of death within 30 days from any cause that was 26% higher than the reference group if their blood glucose levels were between 6.1-7.8 mmol/L, rising to 50% higher if their levels exceeded 11.1 mmol/L. Their risk of death from cardiovascular causes was 28% higher for levels between 6.1-7.8 mmol/L, rising to 64% higher for levels between 9.4-11.1 mmol/L. As their blood glucose levels rose, so did their risk of subsequently developing diabetes; for levels between 6.1-7.8 mmol/L, their risk of diabetes was 61% higher, and this rose by 14% for every 1 mmol/L increase in blood glucose. If their levels exceeded 11.1 mmol/L, their risk of diabetes was 261% higher.
Associate Professor of Medicine, Dr Douglas Lee, a senior scientist at the ICES, who led the research, said: “Although diabetes is a known risk factor for developing heart failure, this is the first time that it has been shown that heart failure predisposes people to developing diabetes.”
