Heart Disease Expert Forum
Diabetes and CABG
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Diabetes and CABG


  As a diabetic (Type II) what specific complications are possible with the
  Coronary Artery Bypass Graft Surgery (Triple) that I am expecting to have in the near future?.  I understand that the time needed for a diabetic's system to recover is increased because of the disease.
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Dear Carmine,
I apologize for the delay in answering your question, however even if you have had your surgery already you have not missed out on any information.
As you may already know CABG is effective way to relieve angina in all patients not just diabetics.  It has unfortunately been shown on a few occasions that diabetics do not have as much long term survival following CABG as do those patients without diabetes.
As yet diabetes has not been labeled as a definite risk factor for the progression of atheroslerosis (plaque buildup in the arteries) or as a definite risk factor for needing future re-do CABG.
Currently the thrust in the research industry for Type II diabetics is to evaluate whether or not intensive glycemic control will reduce cardiovascular risk and complications therein.  It is important for you to hear all of this because the CABG you are to undergo is certainly not a cure for your disease; physicians that specialize in cardiology and endocrine diseases which include diabetes are in general
agreement that the hyperglycemia (elevated blood glucose levels)in diabetics is very much a part of the development of atherosclerosis or better known, coronary artery disease.  
Now the final portion of this information is that with better glycemic control one not only slows the development of blockages in their own arteries but also in the grafts that the surgeon places across your blockages.  Also, in getting your actual question, the other derangements of metabloism in a diabetic that lead to things like delayed healing of sternal wounds post bypass are effected by the intensity of glucose control in that patient.
So I say to you now, take control of your disease, get involved in the intensity to which your sugar is "under control", this includes setting goals for yourself.  An important measurement of diabetic control is the HgA1c, a blood test done in your physician's office; normal HgA1c is 4-6% and the ADA (American Diabetic Association) sets the goal for diabetics at a level of <7%.  As stated before there are many clinical trials currently under way to prove the benefit of intensive glycemic control in the diabetic patient.
In conclusion there are no specific complications associated with being diabetic and undergoing bypass surgery, however it is impressive how less well a diabetic does long term post bypass.  Again this is believed in part to be due to poor glycemic control and subsequent progression of disease in these patients.  I would also like to mention that you can decrease your risks overall if you ake an attempt to minimize your other risk factors for coronary artery disease, and examples as such would be quitting any tobacco habits (smoking,etc), having control of your lipids ( this often requires a prescription
from your doctor as well as dietary restrictions),and controlling any elevation of your blood pressure (also achieved with diet, exercise, and medicines from your physician.)  Information provided in the Heart Forum is intended for general informational purposes only, any diagnosis and treatment can only be made by your physician(s).  





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