This study investigated the incidence of, and risk factors for, new-onset diabetes (new diabetes medication or fasting glucose ≥7 mmol/L) and impaired fasting glucose (fasting glucose ≥6·1 mmol/L and <7 mmol/L) in 8291 Italian patients with a myocardial infarction within the previous 3 months, who were free of diabetes at baseline. The total person-years were 26,795 and mean follow-up period was 3.2 years. 998 patients (12%) developed new-onset diabetes (incidence 37 cases per 1000 person-years). Among 7533 patients without impaired fasting glucose at baseline, 2514 (33%) developed new-onset impaired fasting glucose or diabetes (incidence 123 cases per 1000 person-years), increasing to 3859 (62%) of 6229 with the lower cut-off for impaired fasting glucose of 5·6 mmol/L (incidence 321 cases per 1000 person-years). Risk factors independently associated with new-onset diabetes or impaired fasting glucose included older age, hypertension, use of beta-blockers, lipid-lowering medications (protective), and diuretic use. Independent lifestyle risk-factors included higher body mass index (BMI), greater BMI gain during follow-up, current smoking, a lower Mediterranean dietary score, and wine consumption of more than 1 L/day. Inability to perform exercise testing was associated with higher incidence of diabetes and impaired fasting glucose. In conclusion, the data indicate that myocardial infarction could be a prediabetes risk equivalent, state the authors.
