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Diabetes Patients recover better after Colon Surgery

In terms of postoperative complications and in-hospital mortality, diabetes patients fare better after colon cancer surgery than do persons without diabetes.

“We were really expecting to find the opposite,” exclaimed a surprised Dr. Geoffrey C. Nguyen of the University of Toronto. Dr. Nguyen and his team looked at records for nearly 220,000 people who had colon cancer surgery at U.S. hospitals between 1995 and 2005. Eighty-five percent were without diabetes, 14 percent had uncomplicated diabetes, and 1 percent had diabetes with complications.

The rates of in-hospital mortality were 3.2 percent among those without diabetes and 2.5 percent among diabetes patients. The difference only appeared among patients with uncomplicated diabetes, 2.4 percent of whom died, compared to 4.2 percent of the patients with complicated diabetes, translating to a 29 percent lower risk of death among patients with uncomplicated diabetes.

The study also found that 28 percent of patients with uncomplicated diabetes had surgical complications compared to 31 percent of those without diabetes, giving them an 18 percent lower risk.

When the researchers analyzed subgroups of patients, they found that differences in survival and complication rates between those without diabetes and patients with uncomplicated diabetes, only appeared in individuals older than 50 years, and among those who had health insurance.

Both these findings indirectly support the hypothesis that perioperative care was what made the difference for diabetes patients, Dr. Nguyen said. Patients with insurance might have had access to better care, and doctors are more likely to be more vigilant in older patients.

“At this point, this is meant to stimulate further research,” he added. If it did turn out that perioperative care was the factor that helped diabetes patients do better, he said, the findings could have much wider implications.

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