Prednisone‐glucose Tolerance and Serum Lipids in Survivors of Myocardial Infarction

Abstract Glucose tolerance has been examined by means of a prednisone‐glucose tolerance (PGT) test in 41 patients with clinically documented myocardial infarction 3 to 4 weeks after the attack and in age‐matched control subjects without clinical evidence of cardiovascular disease. In addition serum cholesterol and triglyceride levels have been determined and free fatty acid (FFA) concentrations measured prior to the PGT test and after administration of the glucose load. Abnormal glucose tolerance curves were obtained in 53.6% of the patients 3 to 4 weeks after the infarction and in 25.8% of the controls. Seventeen patients were retested approximately six months after the first test and glucose tolerance in seven patients with initially abnormal PGT curves was found to be within normal limits, while further impairment was observed in only four cases. A significant correlation between the PGT tests and serum cholesterol levels was found to exist only in patients over the age of 60, while no correlation could be observed between prednisone‐glucose tolerance and serum triglycerides or fasting levels of FFA. The mean decrease of FFA 1 hour after the administration of glucose was slightly less in the patients with myocardial infarction than in the controls, while a decrease of FFA to levels below 200 μEq/1 was observed in approximately one third of the patients 1 and/or 3 hours after the glucose load. It is concluded that the impairment of glucose tolerance which frequently can be observed after recent myocardial infarction is probably due only in a minority of cases to a latent diabetic condition and that other factors which are known to influence carbohydrate metabolism must be taken into consideration in explaining the observed disturbances of glucose homeostasis.