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Vascular surgery in diabetes widely embraced. (Outcomes Similar to Nondiabetics).
MITCHEL L. ZOLER
Vascular surgery should not be withheld from patients with diabetes.
The long-held belief that patients with diabetes have a markedly worse perioperative outcome after vascular surgery, compared with patients with normal sugar metabolism steadily crumbled during the 1990s.
A recent success story for vascular surgery in diabetes was a report from surgeons at Beth Israel Deaconess Medical Center in Boston. Those investigators reported their experience during 1990-2000 treating more than 3,100 patients with diabetes and almost 2,000 patients without diabetes.
In this series, the perioperative rates of death, myocardial infarction, and congestive heart failure were essentially identical for patients regardless of whether or not they had diabetes.
The total incidence of these three end points was just under 4% for the entire patient population (Arch. Surg. 137[4]:417-21, 2002).
"The prevailing view among vascular surgeons is to offer corrective, vascular surgery to patients with diabetes," commented Dr. James Menzoian, who is chief of vascular surgery at Boston Medical Center.