Insulin use is associated with poor limb salvage and survival in diabetic patients with chronic limb ischemia Hasan H. Dosluoglu, MD, Purandath Lall,

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Presentation transcript:

Insulin use is associated with poor limb salvage and survival in diabetic patients with chronic limb ischemia Hasan H. Dosluoglu, MD, Purandath Lall, MD, Nader D. Nader, MD, PhD, Linda M. Harris, MD, Maciej L. Dryjski, MD Journal of Vascular Surgery Volume 51, Issue 5, Pages 1178-1189 (May 2010) DOI: 10.1016/j.jvs.2009.11.077 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Overall survival after revascularization. Non-DM, nondiabetic group; D-OM, diet-controlled or oral medication-controlled group; OM+INS, oral medication plus insulin-controlled group; INS, insulin-only group. Non-DM and D-OM groups were each significantly better than OM+INS and INS groups (P < .001). Journal of Vascular Surgery 2010 51, 1178-1189DOI: (10.1016/j.jvs.2009.11.077) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 Limb salvage rates in groups after revascularization procedures. Non-DM, nondiabetic group; D-OM, diet-controlled or oral medication-controlled group; OM+INS, oral medication plus insulin-controlled group; INS, insulin-only group. Non-DM and D-OM groups were each significantly better than OM+INS and INS groups (P < .001); OM+INS vs INS, P = .094. Journal of Vascular Surgery 2010 51, 1178-1189DOI: (10.1016/j.jvs.2009.11.077) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Limb salvage following open revascularization in patients who presented with critical limb ischemia. Non-DM, non-diabetic group; D-OM, diet-controlled or oral medication-controlled group; OM+INS, oral medication plus insulin-controlled group; INS, insulin-only group. Non-DM vs D-OM, P = .244; D-OM vs OM+INS and INS, P = .024; non-DM vs OM+INS and INS, P = .019. Journal of Vascular Surgery 2010 51, 1178-1189DOI: (10.1016/j.jvs.2009.11.077) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 Limb salvage following endovascular revascularization in patients who presented with critical limb ischemia. Non-DM, nondiabetic group; D-OM, diet-controlled or oral medication-controlled group; OM+INS, oral medication plus insulin-controlled group; INS, insulin-only group. Non-DM vs OM+INS, P = .005; D-OM vs OM+INS, P = .072; OM+INS vs INS, P = .042; INS vs non-DM, or D-OM, P < .001. Journal of Vascular Surgery 2010 51, 1178-1189DOI: (10.1016/j.jvs.2009.11.077) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 Primary patency following endovascular revascularization. Non-DM, nondiabetic group; D-OM, diet-controlled or oral medication-controlled group; OM+INS, oral medication plus insulin-controlled group; INS, insulin-only group. Non-DM vs INS, P < .001; D-OM vs INS, P = .002; non-DM vs OM+INS, P = .053; D-OM vs OM+INS, P = .068. Journal of Vascular Surgery 2010 51, 1178-1189DOI: (10.1016/j.jvs.2009.11.077) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 6 Secondary patency following endovascular revascularization. Non-DM, nondiabetic group; D-OM, diet-controlled or oral medication-controlled group; OM+INS, oral medication plus insulin-controlled group; INS, insulin-only group. Non-DM vs INS, P = .007; D-OM vs INS, P = .009; OM+INS vs INS, P = .013; non-DM vs D-OM or OM+INS, P = NS. Journal of Vascular Surgery 2010 51, 1178-1189DOI: (10.1016/j.jvs.2009.11.077) Copyright © 2010 Society for Vascular Surgery Terms and Conditions