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The influence of pre-admission hypoglycaemic therapy on cardiac morbidity and mortality in type 2 diabetic patients undergoing major non-cardiac surgery: a prospective observational study*
MedLine Citation:
PMID:  22066687     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
It remains unclear whether type 2 diabetics treated with either insulin or oral hypoglycaemic agents have the same incidence of cardiac morbidity and mortality after major non-cardiac surgery. We prospectively studied 360 type 2 diabetic patients undergoing major non-cardiac surgery of which 105 were treated with insulin only, 171 were treated with oral hypoglycaemics only and 84 were treated with a combination of insulin and oral hypoglycaemics. All-cause mortality after 30 days and after 12 months was highest in the insulin (10% and 26%) and lowest in the oral hypoglycaemics group (2% and 13%; p = 0.02 and 0.007, respectively). Insulin treatment was independently associated with increased mortality after 30 days (hazard ratio 3.93; 95% CI 1.22-12.64; p = 0.022) and 12 months (hazard ratio 2.03; 95% CI 1.16-3.58; p = 0.014) after multivariate adjustment for age, sex and the revised cardiac risk index (insulin treatment excluded). The increased mortality in insulin-treated diabetic patients may be due to a more progressive disease state in these patients rather than the treatment modality itself. You can respond to this article at http://www.anaesthesiacorrespondence.com.
Authors:
D Bolliger; M D Seeberger; G Lurati Buse; P Christen; E Seeberger; W Ruppen; M Filipovic
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-9
Journal Detail:
Title:  Anaesthesia     Volume:  -     ISSN:  1365-2044     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Affiliation:
 Staff Anaesthetist  Professor and Senior Staff Anaesthetist  Anaesthetist  Research Associate, Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, Basel, Switzerland  Senior Staff Anaesthetist, Department of Anaesthesia, Cantonal Hospital Lucerne, Lucerne, Switzerland  Professor and Senior Staff Anaesthetist, Institute of Anaesthesiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
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