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).
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