In this prospective cohort of over 400 non-diabetic patients undergoing vascular surgery, they all underwent fasting and oral glucose tolerance (OGTT) before surgery, and followed for up to 3 years after surgery. Of the 404 patients, 26% were found to have impaired glucose tolerance (fasting blood sugar 100-125 or OGTT 140-199) and another 11% were found to have diabetes (fasting >126 or OGTT > 200). Those with impaired tolerance had a much greater risk of long term cardiovascular events than normal controls (HR 2.77, CI 1.83-4.2). The authors call for routine fasting and OGTT testing on all vascular surgery patients, although this likely needs to be validated and assessed for cost-effectiveness across other institutions before routine use (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.