Parr MS, et al. - Here, the researchers compared patients with explicitly controlled and uncontrolled diabetes at the population level. Following carotid endarterectomy (CEA), patients with uncontrolled diabetes had poorer outcomes than those with controlled diabetes, whose outcomes were comparable to if not better than individuals without diabetes.

Methods

• The researchers selected patients undergoing CEA using the National Inpatient Sample 2006–2013.
• They compared rates of stroke, myocardial infarction (MI), and hospital mortality, as well as the duration of stay and cost, among patients with uncontrolled diabetes (UCDM), well-controlled diabetes (WCDM), and those without diabetes (NDM).

Results

• Data was reviewed from 614,190 patients undergoing CEA.
• Compared with those with WCDM and NDM, patients with UCDM had higher rates of stroke (3.27%, 0.93%, and 0.94%, respectively; P < .0001), MI (3.35%, 1.10%, and 0.87%, respectively; P < .0001), and higher hospital mortality (1.43%, 0.25%, and 0.27%, respectively; P < .0001).
• Patients with UCDM compared with WCDM were more likely to develop stroke (odds ratio[OR], 1.45; 95% confidence interval [CI], 1.23-1.71), and MI (OR, 2.26; 95% CI, 1.96-2.60) and were more likely to die (OR, 2.74; 95% CI, 2.19-3.42) in multivariate analysis.
• Similar likelihoods of stroke (OR, 0.96; 95% CI, 0.90-1.02) and MI (OR, 1.04; 95% CI, 0.98-1.10) were observed for patients with WCDM compared with patients without diabetes.
• However, patients with WCDM were actually less likely to die compared with patients without diabetes (OR, 0.85; 95% CI, 0.76-0.95).