Coronary artery bypass linked to new-onset diabetes

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Coronary artery bypass surgery may lead to metabolic changes, causing new-onset diabetes.
Coronary artery bypass surgery may lead to metabolic changes, causing new-onset diabetes.

Coronary artery bypass (CABG) surgery may lead to metabolic changes resulting in new-onset diabetes, new data suggest. 

Researchers from India reported that CABG surgery restores vascularization, but it also may introduce a new cardiovascular risk in the form of diabetes. The investigators believe CABG surgery patients who have prediabetes or carry other risk factors for diabetes appear to be at the highest risk for post-procedure new-onset diabetes. The investigators found that in these patients, certain factors were associated with the development of diabetes. The study showed that significant risk factors appeared to be the stress of surgery, inotrope usage, and prolonged duration of ICU stay.

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“We included 1559 patients,933 were nondiabetics, and 6.1 % of nondiabetics were detected to be diabetic after CABG,” said Sailesh Lodha, MD, a consultant endocrinologist in Jaipur, India.

He and his team examined the incidence of new diabetes and the impact of diabetes on ICU and hospital stay in patients undergoing CABG surgery. The researchers prospectively collected data among 1559 consecutive adult cardiac surgical patients who underwent CABG surgery. The cohort consisted of 1355 men and 254 women. There were 933 patients without diabetes and 626 patients with diabetes.

The researchers found that among the 933 patients without diabetes, 6.1% (n=57) continued to have persistently high blood glucose levels at hospital discharge, and these cases were diagnosed as diabetes de novo or new-onset diabetes. The researchers reported the incidence rate was 61 per 1000, and there was a strong association between the duration of ICU stay and development of diabetes (r=0.138) and overall hospital stay and development of diabetes (r=0.163).  

The researchers noted that 44.6 % of the patients who developed diabetes postoperatively had impaired glucose tolerance (random glucose >140 mg/dL) preoperatively. However, only 13.7 % in the group with diabetes developed diabetes postoperatively. 

“All patients who are undergoing major surgeries should also be screened by HbA1c prior to surgery,” said Dr Lodha. 

The researchers stated that this is an issue that needs to be addressed in light of the fact that the rates on new-onset diabetes were found to be so high following CABG surgery.

In some ways this study may be a wake-up call, according to the researchers. Dr Lodha and his colleagues wrote that more research is warranted because the development of diabetes in patients without diabetes soon after CABG may not only have important clinical implications but also economic ramifications.

This article originally appeared on EndocrinologyAdvisor.com as a part of their coverage of the 2016 AACE Annual Scientific and Clinical Congress. 

Reference

  1. Lodha S, Bana A, Mehta N, Sharma K, Gupta R. Abstract 1305. Incidence of New Diabetes Following CABG Surgery: Analysis of a Single Centre Registry Data. Presented at: AACE 25th Annual Scientific & Clinical Congress; May 25-29, 2016; Orlando, FL.
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