Diabetes type affects joint replacement outcomes
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People with type 1 diabetes who undergo total hip or knee replacement generally fare worse than people with type 2 diabetes, who in turn do worse than non-diabetic patients, according to study findings presented this week at the meeting of the American Academy of Orthopaedic Surgeons in San Francisco.
“The biggest finding was that diabetes predicted higher complication rates, and this is obviously not a huge surprise,” researcher Dr. Michael P. Bolognesi, from Duke University Medical Center in Durham, North Carolina, told Reuters Health.
While type 1 diabetic patients overall did worse than type 2 diabetics, he added, the very worst outcomes were actually seen in a subgroup of type 2 diabetics with uncontrolled disease.
The findings are based on an analysis of data for 65,769 diabetic patients who underwent joint replacement surgery and were entered in a database from 1988 to 2003.
Compared with patients with type 2 diabetes, those with type 1 diabetes had significantly longer hospital stays and higher costs following surgery after adjusting for inflation.
Type 1 diabetics were also at increased risk for a heart attack, pneumonia, urinary tract infection, post-operative bleeding, wound infection, and death.
The team’s analysis suggests that these patients can be helped by making sure their blood glucose levels are under control before the operation and during the recovery period, Bolognesi pointed out.
Furthermore, he emphasized, “Physicians need to be aware of the fact that these patients do worse across the board, and do everything they can to minimize complications—and be ready to address them, as they will likely occur.”
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