Surgery 'improves heart outcome' in diabetes

Diabetes - Coronary bypass can improve outcomes compared with medication alone, according to research.

Prompt coronary bypass surgery can improve cardiovascular outcomes for patients with type-2 diabetes and heart disease compared with intensive medical therapy alone, research shows.

Over 2,000 patients with type-2 diabetes and heart disease were assigned to either prompt revascularisation with intensive medical therapy or intensive medical therapy alone.

Patients also received either insulin sensitisation or insulin provision therapy.

The primary end points of the study, results of which were published last week in the New England Journal of Medicine, were the rate of death and a composite of major cardiovascular events, including MI or stroke.

At five years there were no significant differences between the revascularisation and medical therapy group or between the insulin sensitisation and insulin provision groups in the study.

Patients had been stratified according to whether percutaneous coronary intervention or coronary artery bypass grafting was the most suitable intervention for them.

Within the coronary artery bypass grafting subgroup, the patients who received prompt surgery had significantly fewer strokes or MIs than the medical therapy group (22.4 per cent compared with 30.5 per cent).

Adverse events were generally similar across the groups in the study.

The authors said that the take-home message for patients was the reassurance that diabetes can be controlled using either regimen.

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