Endocrine Abstracts (2006) 11 P423

Correlation between glycemia levels and mortality rate in patients with type 2 diabetes and prior myocardial infarction

M Dundua, N Asatiani, R Kurashvili, M Khelashvili, L Tsutskiridze & E Shelestova

Georgian Diabetes Center, Tbilisi, Georgia.

It is clear that effective control of blood glucose, hypertension and dyslipidemia, may prevent development of vascular complications in type 2 diabetes (T2DM).

The aim of the present work was to reveal correlation between glycemia levels and mortality rate in T2DM patients (pts) with prior myocardial infarction (PMI).

Materials: Totally, 131 T2DM pts with PMI were studied (mean age – 57.2±3.1 yrs; diabetes duration – 6.5±2.8 yrs). Pts were supervised for 6 months. According to their glycemia control pts were divided into 2 groups (Gr.): Gr.1, n=72 – home-blood glucose monitoring (five-point profiles, 3 profile days/weekly). Oral hypoglycemic agents (OHAs) were administered in 53 pts, and 19 were treated with insulins and OHAs. Gr.2, n=59 – scarce blood glucose control (2–3 times/monthly); 49 pts were treated with OHAs and 10 – with insulins and OHAs.

Results: Data at entry revealed that glycemia and HbA1c levels were practically identical for both groups: HbA1c (Gr.1 – 7.9±0.4%; Gr.2 – 8.1±0.6%, P=0.024), fasting glycemia (FG) – (Gr.1 – 140.5±39.15 mg/dl; Gr.2 – 139.3±36.1 mg/dl, P=0.857), postprandial glycemia (PG) – (Gr.1 – 162.5±32.43 mg/dl; Gr.2 – 169.1±28.6 mg/dl, P=0.197) There was no statistically evident difference between the groups. Repeated examination at month 6 revealed: HbA1c (Gr.1 – 6.0±0.3%; Gr.2 – 7.5±0.7%, P=0.000), FG – (Gr.1 – 101.5±39.15 mg/dl; Gr.2 – 131.1±17.8 mg/dl, P=0.000), PG – (Gr.1 – 124.7±20.8 mg/dl; Gr.2 – 158.1±28.6 mg/dl, P=0.000). Totally, during the 6-month follow-up period, five Gr.1. (6.9%) patients died, all of them having repeated MI. In Gr.2, seven out of 10 deaths (16.9%) were caused by repeated MI.

Conclusion: T2DM patients with PMI, and PG <130 mg/dl showed lower mortality rate (6.9%), than those with PG >150 mg/dl (mortality rate – 16.9%). According to our data 30 mg/dl decrease in PG, 30–40 mg/dl decrease in FG and 1.5% drop in HbA1c levels result in 10% decline in mortality rate.

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