Beth Israel Deaconess study documents outstanding surgical outcomes for diabetes patients

April 14, 2002

BOSTON - Contrary to the long-held belief that surgery poses a significant danger to patients with diabetes mellitus, a 10-year study of more than 6,500 patients from Beth Israel Deaconess Medical Center (BIDMC) has shown a mortality rate of only 1 percent among diabetes patients undergoing major vascular operations.

The findings, published in the April issue of the Archives of Surgery and presented last September at the New England Surgical Society meeting, represent the largest study of this type to conclude that patients with diabetes should be offered the same surgical options as patients without diabetes.

"These results show mortality rates that are dramatically lower than the national average in patients both with and without diabetes," according to lead author Allen D. Hamdan, M.D., of BIDMC's Department of Vascular Surgery, explaining that mortality rates of between 4 and 6 percent would typically be expected. "This study is exciting both for the low overall mortality rate that was shown, as well as for the fact that diabetes mellitus was not found to be an independent predictor of morbidity or mortality during hospitalization for surgery," says Hamdan.

Patients with diabetes mellitus are at an increased risk for vascular diseases in all the body's arteries, including the legs and lower extremities. This can often lead to ulceration and, potentially, amputation.

"These study results are especially good news for diabetes patients who might otherwise have to undergo amputation," explains Frank W. LoGerfo, M.D., Chief of Vascular Surgery at BIDMC. "The findings suggest that these patients would be at low risk for complications in lower extremity revascularization surgery, which is performed to restore circulation to the foot and prevent amputation."

Using a comprehensive computerized registry created by LoGerfo and BIDMC vascular surgeons and co-authors Frank B. Pomposelli, Jr., M.D., and David R. Campbell, M.D., the study reviewed the cases of more than 6,500 major vascular procedures over a 10-year period between January 1990 and May 31, 2000. The registry database, which remains in existence, thoroughly documents the surgical outcomes of every patient undergoing vascular surgeries - carotid endarterectomy, aortic reconstruction including treatment of aneurysms, and lower extremity revascularization - at BIDMC. The database also carefully chronicles patient demographics and pre-operative risk factors.

The authors used logistic regression analysis - a statistical method that looks for independent risk factors that might predict an increase in morbidity and mortality during hospitalization for surgery - to evaluate the risks posed by hypertension, coronary artery disease, renal failure and smoking, in addition to diabetes.

Their results showed that diabetes alone did not pose an added risk for patients, a finding in contrast to previous studies. A significant proportion of patients requiring vascular procedures have diabetes, which afflicts an estimated 16 million individuals in the United States, and accounts for health expenditures of $110 billion annually.

"These findings offer patients with diabetes an important option when it comes to their health care," Hamdan notes, attributing the study's positive outcomes to a coordinated approach to patient care among BIDMC vascular surgeons, cardiologists, anesthesiologists, specialized vascular nurses and endocrinology experts from Joslin Diabetes Center. "These results demonstrate that there is no reason to expect anything but excellent results for a number of major vascular procedures in patients with diabetes."
-end-
Study co-authors include current and former BIDMC vascular surgeons Stephanie S. Saltzberg, M.D., Malachi Sheahan, M.D., James Froelich, M.D. and Cameron M. Akbari, M.D.

Beth Israel Deaconess Medical Center is a major patient care, research and teaching affiliate of Harvard Medical School and a founding member of CareGroup Healthcare System. Beth Israel Deaconess is the third largest recipient of National Institutes of Health research funding among independent U.S. teaching hospitals.

Beth Israel Deaconess Medical Center

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.