Among patients with bleeding or perforated peptic ulcers, those with diabetes appear to be at substantially increased risk of dying. Dr. Reimar W. Thomsen, from Aarhus University Hospital in Denmark, and colleagues hypothesized that diabetic patients with complicated peptic ulcer disease may face a higher short-term mortality risk because of diabetic angiopathy, blurring of symptoms, and an increased risk of bacterial sepsis.
To investigate, the researchers assessed the outcomes of 7323 patients hospitalized for bleeding ulcers and 2061 patients with perforated ulcers. Roughly, 10% of the former group and 7% of the latter had diabetes.
Among patients with bleeding ulcers, the 30-day mortality rate was 16.6% in the diabetic group versus 10.1% in the nondiabetic group, the report indicates. This translates into a 40% increased risk of death for the diabetic group.
The mortality difference in the perforated ulcer group was even more pronounced. Diabetic patients had a 30-day mortality rate of 42.9% compared with 24.0% for nondiabetic patients, representing an increased risk of 51%.
"Our findings suggest that efforts to improve outcomes from these medical emergencies in diabetic persons should be directed to reducing preventable diabetes complications," the authors conclude.
Diabetes Care 2006;29:805-810.
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