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Background: Abnormal glucose tolerance (AGT) in non-diabetic patients with acute myocardial infarction is
associated with decreased survival compared to those with normal glucose tolerance (NGT). The aim of this study was to
test if two-hour postprandial glucose (PPG2h) after a mixed meal correlates with the two-hour oral glucose tolerance test
Methods: We prospectively enrolled 189 non-diabetic patients with acute myocardial infarction.
Results: According to the oral glucose tolerance test (OGTT), 37.0% had NGT, 4.8% had impaired fasting glucose, 37.6%
had impaired glucose tolerance (IGT) and 20.6% had diabetes. PPG2h after each meal correlated with OGTT2h (R2=
0.13-0.26, P<0.001). In diabetic patients, PPG2h levels after each meal were higher (p<0.01 for all) than in the IGT and
NGT group. In the NGT and IGT group, PPG2h was higher after lunch and dinner than after breakfast (p<0.01), but this
was not the case in the diabetic patients. In detecting diabetes compared to OGTT2h, PPG2h equal to or above 5.6 mmol/l
after breakfast, 6.5 mmol/l after lunch and 7.0 mmol/l after dinner had a sensitivity of at least 76% and specificity of at
least 42%. Glucose values below the cut-off values suggest that OGTT need not be evaluated.
Conclusion: PPG2h is a quick, practical, simple and easy measurement in clinical practice. PPG2h correlates with OGTT
but the value is lower, so PPG2h cannot be used to evaluate postprandial glycemia with the current OGTT glycemic
thresholds. We therefore suggest the use of new cut-off values for PPG2h after a random meal to select patients in whom
OGTT is not needed to evaluate diabetic status.