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Diagnosing diabetes on admission hyperglycaemia
  1. Ayesha C Qureshi1,2,3,
  2. Andrew P Asherson4,
  3. Ashley B Grossman5,6
  1. 1Department of Cardiology, The London Chest Hospital, Bonner Road, London, UK
  2. 2Department of Translational Medicine, The William Harvey Research Institute, Barts and the London School of Medicine, London, UK
  3. 3On attachment in Clinical Trials and Medical Affairs, Cordis, Waterloo Office Park, Dreve Richelle 161H, 1410 Waterloo, Belgium
  4. 4Specialist Registrar, Department of Cardiology, St George's Healthcare NHS Trust, Blackshaw Road, Tooting, London, UK
  5. 5Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
  6. 6The William Harvey Research Institute, Barts and the London School of Medicine, London, UK
  1. Correspondence to Dr Ayesha C Qureshi, Specialist Registrar in Cardiology, Department of Cardiology, The London Chest Hospital, Bonner Road, London, E2 9JX, UK; drkatiequreshi{at}yahoo.co.uk

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Introduction

Diabetes mellitus and cardiovascular disease are two closely related diseases. In patients with both stable and unstable coronary artery disease (CAD), there is a high prevalence of diabetes and increased rates of both undiagnosed diabetes and impaired glucose metabolism such as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).1 2 Patients with known or newly diagnosed diabetes are at particularly elevated risk for both mortality and adverse cardiac events at 1 year of follow-up.2 Cardiovascular disease is currently the leading cause of death worldwide.3 At the same time, there is a worldwide epidemic of diabetes mellitus, with over 280 million (6.4%) of the world's population affected.4 There is therefore a need for a closer working relationship between diabetologists and cardiologists in order to improve the management of such patients.5 Thus, if one sees a patient with suspected CAD, it is extremely important to confirm whether or not he or she has diabetes and, in due course, to treat it effectively. This is especially true in the case of an acute coronary syndrome (ACS). One method that has been used is the assessment of admission hyperglycaemia, which has been shown to increase subsequent cardiovascular events.6 Patients presenting with ACS and documented hyperglycaemia on admission …

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