Continuous glucose monitoring as a tool to identify hyperglycaemia in non-diabetic patients with acute coronary syndromes

Aim
To explore the occurrence and the distribution of glucose excursions > 7.8 mmol/l by continuous glucose monitoring
(CGM) in non-diabetic patients admitted with acute coronary syndrome (ACS).
Methods
Twenty-one non-diabetic patients without baseline hyperglycaemia admitted for ACS wore a continuous
glucose monitoring system (CGMS) for a median period of 45.6 h. Occurrence and 24-h distribution of time spent with
blood glucose > 7.8 mmol/l (TS > 7.8) were retrospectively investigated.
Results
CGMS data disclosed time spent > 7.8 in 17 patients, whereas only seven of them showed at least one capillary
blood glucose test value above the threshold for the same time period. Glucose excursions were detectable earlier from
CGMS data. Hyperglycaemia was detected most frequently in the morning, more than 2 h after breakfast.
Conclusions
CGM discloses early and frequent hyperglycaemia in non-diabetic patients with ACS. Intensive glucose
monitoring during the morning time period is the most efficient in screening for hyperglycaemia and could be a valuable
guide to initiating insulin therapy and to further investigate outcomes in ACS.