Surgery judged preferred option for diabetes and atherosclerosis treatment

Surgery may be the best way to treat an artery condition in people with type 1 diabetes, a new study suggests.
Researchers from the Karolinska Institutet in Sweden say their research provides them with more clarity on the best way to treat atherosclerosis in people with type 1 diabetes.
They compiled their findings after following up with people with type 1 diabetes who underwent a non-surgical operation called percutaneous coronary intervention (PCI) between 1995 and 2013. PCI involves using a stent to open up the heart’s blood vessels which have narrowed because of plaque build-up.
They found those who had participated in the procedure were at a 45 per cent higher risk of suffering from fatal heart disease and had a 47 per cent higher chance of risk of having a heart attack compared to those who had undergone coronary artery bypass surgery (CABG).
Further treatment was also required for those who underwent PCI at a later date, the researchers said.
Guidance has always been unclear regarding the use of CABG to widen heart arteries in people with type 1 diabetes, but these findings support the surgery’s benefits.
Martin Holzman, researcher at Karolinska Institutet’s Department of Medicine in Solna, said: “Since type 1 diabetes is a different disease with different complications, it’s never been given that the treatment should be the same as with type 2 diabetes.”
“The results suggest that CABG should also be the preferred procedure for patients with type 1 diabetes and two or more diseased coronary vessels, as currently stated in guidelines for diabetes patients.
“PCI is easier to perform and isn’t so invasive for the patient, so there are arguments in favour of this method too.”
The study authors found that the relative number of CABG procedures declined during this study period, and hope their findings will impact future decision-making in this field.
The findings were published in the Journal of the American College of Cardiology.

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