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High blood sugar levels in heart failure patients connected to early death

Testing blood sugar levels of people who arrive at hospital emergency departments with heart failure could prevent early deaths, according to new research.
The study, published online in the European Heart Journal, suggests that the inexpensive test could also reduce the risk of further hospitalisations and the development of health issues such as type 2 diabetes.
Acute heart failure syndromes (AHFS) are one of the most common reasons for emergency department visits, and are associated with high mortality rates.
The study
The study, conducted at the Institute for Clinical Evaluative Sciences (ICES), the Peter Munk Cardiac Centre at the University Health Network, and the University of Toronto, aimed to assess the implications of blood sugar levels on some of the outcomes of AHFS, including early mortality, hospitalisatio, and diabetes.
Researchers analysed 16,524 AHFS patients whose condition had forced them to visit an emergency department in Ontario, Canada between 2004 and 2007. Of the patients, all of whom were aged 70-85 years, 49 per cent were men, and 56 per cent had no pre-existing diabetes.
The results
The results of their blood glucose tests were compared to a reference group. Every patient in the reference group had blood glucose levels ranging from 3.9-6.1 mmol/L (under 5.9 mmol/L is generally considered to be a non-diabetic blood sugar level).
When the patients without pre-existing diabetes were compared to the reference group, the researchers discovered a:
26 per cent higher risk of death within 30 days from any caused with blood glucose levels between 6.1-7.8 mmol/L
50 per cent increase in risk of death from any cause with blood glucose levels higher than 11.1 mmol/L
28 per cent increase in risk of death from cardiovascular disease for those patients with blood glucose levels between 6.1 and 7.8 mmol/L
64 per cent increase in risk of death from cardiovascular causes for blood glucose levels between 9.4 and 11.1 mmol/L
61 per cent higher risk of diabetes for blood glucose levels between 6.1-7.8 mmol/L
261% increase in risk of diabetes for glucose levels higher than 11.1 mmol/L
For every 1 mmol/L increase in blood glucose, patients increased their risk of developing type 2 diabetes by 14 per cent.
What do the results mean?
In short, the study indicates that even those individuals who arrive at emergency departments without a prior diagnosis of diabetes and with non-diabetic blood sugar ranges, having levels exceeding 6.1 mmol/L significantly increases the risk of developing type 2 diabetes, as well as early death.
Dr. Douglas Lee, Associate Professor of Medicine and a senior scientist at the ICES, who led the research, explained: “Among patients without pre-existing diabetes, the majority (51 per cent) had blood glucose levels on arrival at the hospital that were within ‘normal’ limits but greater than 6.1 mmol/L.
“Our results suggest that all such patients should undergo further testing for diabetes before discharge. If the hospital tests show that their fasting blood glucose is not elevated, then they should be monitored subsequently for the development of diabetes as outpatients.
“Although diabetes is a known risk factor for developing heart failure, this is the first time that is has been shown that heart failure predisposes people to developing diabetes.”

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