Test acute coronary syndrome patients for diabetes, says NICE

GPs should test annually for diabetes in all patients with acute coronary syndromes (ACS) and raised HbA1c, NICE has said.

In a new guideline published on Wednesday, it said such patients should be told they are at increased risk of type-2 diabetes and offered lifestyle advice as well as the yearly checks.

The guideline focuses on the role of intensive insulin therapy in the acute management of hyperglycaemia in ACS, but also following discharge.

Research suggests 65% of patients with acute myocardial infarction but without diagnosed diabetes have impaired glucose regulation as shown by a glucose blood test.

Dr Fergus Macbeth, director of the centre for clinical practice at NICE, said: ‘We know that hyperglycaemia in patients who are admitted to hospital with ACS is a powerful predictor of poorer survival and increases the risk of complications, regardless of whether or not they have diabetes. I am sure this guideline will be a useful aid for healthcare professionals who treat and manage this condition.’

NICE also announced it has approved the use of the 'clot-busting' antiplatlet drug ticagrelor in final guidance.

The treatment can now be prescribed on the NHS in combination with aspirin to prevent clot formation in ACS patients.

Ticagrelor was approved for use in NHS Scotland back in May. Research had shown it could cut the relative risk of cardiovascular death by 21% and repeat cardiovascular events by 16% compared with standard care, with no increase in major bleeding.

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