Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/16547
Title: Mandatory oral glucose tolerance tests identify more diabetics in stable patients with chronic heart failure: a prospective observational study.
Authors: STEVENS, An 
HANSEN, Dominique 
Vandoren, Vincent
Westerlaken, Rob
CREEMERS, An 
OP 'T EIJNDE, Bert 
DENDALE, Paul 
Issue Date: 2014
Source: Diabetology & Metabolic Syndrome, 6(1), (ART N° 44)
Abstract: BACKGROUND: Many patients with chronic heart failure (CHF) are believed to have unrecognized diabetes, which is associated with a worse prognosis. This study aimed to describe glucose tolerance in a general stable CHF population and to identify determinants of glucose tolerance focusing on body composition and skeletal muscle strength. METHODS: A prospective observational study was set up. Inclusion criteria were diagnosis of CHF, stable condition and absence of glucose-lowering medication. Patients underwent a 2 h oral glucose tolerance test (OGTT), isometric strength testing of the upper leg and dual energy x-ray absorptiometry. Health-related quality of life and physical activity level were assessed by questionnaire. RESULTS: Data of 56 participants were analyzed. Despite near-normal fasting glucose values, 55% was classified as prediabetic, 14% as diabetic, and 20% as normal glucose tolerant. Of all newly diagnosed diabetic patients, 79% were diagnosed because of 2 h glucose values only and none because of HbA1c. Univariate mixed model analysis revealed ischaemic aetiology, daily physical activity, E/E', fat trunk/fat limbs and extension strength as possible explanatory variables for the glucose curve during the glucose tolerance test. When combined in one model, only fat trunk/fat limbs and E/E' remained significant predictors. Furthermore, fasting insulin was correlated with fat mass/height2 (r = 0.51, p < 0.0001), extension strength (r = -0.33, p < 0.01) and triglycerides (r = 0.39, p < 0.01). CONCLUSIONS: Our data confirm that a large majority of CHF patients have impaired glucose tolerance. This glucose intolerance is related to fat distribution and left ventricular end-diastolic pressure.
Notes: Stevens, ALM (reprint author), Hasselt Univ, REVAL Rehabil Res Ctr, Martelarenlaan 42, BE-3500 Hasselt, Belgium, an.stevens@uhasselt.be
Keywords: insulin resistance; body composition; muscle strength; quality of life
Document URI: http://hdl.handle.net/1942/16547
e-ISSN: 1758-5996
DOI: 10.1186/1758-5996-6-44
ISI #: 000334617500001
Rights: © 2014 Stevens et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Category: A1
Type: Journal Contribution
Validations: ecoom 2015
Appears in Collections:Research publications

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