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Diabetes No Reason to Hesitate About Vascular Surgery

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Diabetes No Reason to Hesitate About Vascular Surg

Diabetes No Reason to Hesitate About Vascular Surgery

January 02, 2003
(AP) - People with diabetes have better postoperative survival rates following vascular surgery than people without diabetes, according to a new study.

The study was published in the April 2002 Archives of Surgery. The authors wanted to test the widely held belief that people with diabetes are at high risk for death following major vascular surgery (surgery on the carotid artery, the aorta, or a leg artery). Many people who need vascular surgery have diabetes. So knowing exactly how safe the procedure is for people with diabetes is important.

The researchers collected data from Jan. 1, 1990, through May 31, 2000, on all patients having major vascular surgery at their hospital. During this time, 5,126 people had 6,565 procedures. About two-thirds of the patients had diabetes. The researchers then compared overall postoperative death rate, heart attack rate, and congestive heart failure in people with and without diabetes.

Contrary to common wisdom, the people with diabetes had significantly lower postoperative death rates-0.96 percent died versus 1.46 percent of the people without diabetes. Rates of heart attack and congestive heart failure were not significantly different between the two groups.

The researchers then looked at what traits influenced the patients' short-term survival rates. People who had undergone dialysis were three times as likely to die following surgery as those who had not, and those with congestive heart failure were twice as likely to die. Having already had a heart attack doubled the risk of having a heart attack after vascular surgery. People who had high blood pressure or congestive heart failure before surgery were roughly twice as likely to have congestive heart failure afterwards.

The researchers were uncertain why people with diabetes fared better after vascular surgery.

(By five years after the surgery, however, a higher percentage of the people with diabetes had died compared with the people without diabetes. The reason for this remains unknown.)

This study is good news if you need major blood vessel surgery. It indicates that you can weigh the pluses and minuses of the surgery without worrying about any additional, immediate postoperative risks caused by diabetes.

Shauna S. Roberts, PhD, is a science writer from New Orleans, La.

Copyright American Diabetes Association Jan 2003

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