In previous studies, the death rate on the procedure has been as high as 4 percent, says study author Dr. Allen D. Hamdan
"Having diabetes does not predict a higher risk for vascular surgery.In fact, there was a lower morbidity rate," says Hamdan, a vascular surgeon at Deaconess and an assistant professor of surgery at Harvard Medical School.
"What this means is that people with diabetes should be treated like anyone else, on a case-by-case basis, with regard to surgery."
There are about 16 million persons with diabetes in the United States, and 800,000 new cases are diagnosed each year, Hamdan
says.The disease compromises the circulatory system, so persons with diabetes have significantly more vascular problems such as clotting and risk of gangrene in their outer limbs.
"It is an underlying truth" that patients with diabetes have accelerated hardening of the arteries that leads to problems all over the body at an earlier age and at a more accelerated rate, he
This led to the belief that "diabetics were felt to have a different type of vascular damage than non-diabetics.The feeling was that those with diabetes had worse blockages than people without diabetes," Hamdan
says."Because of this, simply the presence of diabetes was thought to be an indicator of higher risk for surgery."
As a result, he
says, patients were-and still are-often advised to have amputations rather than vascular surgery that might improve circulation.
However, Hamden and his
colleagues statistically analyzed outcomes for surgeries in the arteries of the neck and extremities, as well as arteries leading to the heart.They found diabetics had a death rate of 0.96 percent, compared with a 1.46 percent rate for non-diabetics who had the same operation.Hamden says the results were a surprise.
department works very closely with the Joslin Diabetes Center
in Boston, and the outcome might reflect their careful attention to persons with diabetes.
"We have a very coordinated, multi-disciplinary system with close ties to endocrinologists, cardiologists, anesthesiologists, and nurses who specialize in diabetes," he