Structured diabetes care routines in cardiac rehabilitation are associated with increased diabetes detection and improved treatment after myocardial infarction: a nationwide observational study
Main finding · Newly detected diabetesResult — go to the resultRelative risk 1.62 95% CI 1.26–1.98Authors' conclusion
Having structured routines for diabetes care implemented within CR can improve detection and treatment of diabetes post-MI. A cluster-randomized trial is warranted to ascertain causality.
Study context
- Population
- All post-MI patients irrespective of diabetes diagnosis, SWEDEHEART registry, 76 Swedish cardiac rehabilitation (CR) centers; 76% male, mean age 62.6 years
- Participants
- 7,601 patients76 CR centers
- Exposure
- Patients exposed vs not exposed to structured diabetes care routines in CR
- Fasting glucose/HbA1cn = 48
- Oral glucose tolerance test (OGTT)n = 29
- Case rounds with diabetologistsn = 7
- Medication adjusted by CR physiciansn = 13
- Outcome
- Newly detected diabetes and proportion receiving oral glucose-lowering medication
- Follow-up
- One-year post-MI
Methodological detailscenter-level survey linked to national registry, mixed-effects regression
- Center-level survey linked to national registry
- Mixed-effects regression
Main finding
Newly detected diabetes · one-year
Relative risk
1.62
95% CI 1.26–1.98
P = 0.0007
OGTTvs Not exposed
RR 1.62 (95% CI 1.26–1.98); P = 0.0007
As reported in the abstract
- Newly detected diabetes, all patients
- 4.0% (n = 304)
Observational data: associations, not effects.
Further findings
| Outcome | RR (CI) | P value | |
|---|---|---|---|
| Oral glucose-lowering medication · one-yearOGTTvs Not exposed | 1.22 (1.07–1.37) | P = 0.0046 | |
| Oral glucose-lowering medication · one-yearMedication adjusted by CR physiciansvs Not exposed | 1.31 (1.06–1.56) | P = 0.0155 | |
| 0.512Relative risk (log scale) |
- Oral glucose-lowering medication — On oral glucose-lowering treatment, all patients
- 17.9% (n = 1361)
Newly detected diabetes by number of routines
- 0 routines
- 2.7%
- 4 routines
- 6.3%
- Trend
- P for trend = 0.0014
Centers implementing routines
- Fasting glucose/HbA1c
- 63.2% (n = 48)
- OGTT
- 38.2% (n = 29)
- Medication adjusted by CR physicians
- n = 13, 17.1%
- Case rounds with diabetologists
- n = 7, 9.2%
Original publication
Structured diabetes care routines in cardiac rehabilitation are associated with increased diabetes detection and improved treatment after myocardial infarction: a nationwide observational study. Cardiovasc Diabetol. Published 3 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →