Diabetes makes ulcers more deadly

Among patients with bleeding or perforated ulcers, those with diabetes appear to be at substantially increased risk of dying, according to a report in the journal Diabetes Care.

Dr. Reimar W. Thomsen, from Aarhus University Hospital in Denmark, and colleagues hypothesized that diabetic patients with complicated ulcer disease may face a higher short-term death risk because of diabetic blood vessel problems, blurring of symptoms, and an increased risk of overwhelming bacterial infection.

To investigate, the researchers assessed the outcomes of 7323 patients hospitalized for bleeding ulcers and 2061 patients with perforated ulcers. Roughly, 10 percent of the former group and 7 percent of the latter had diabetes.

Among patients with bleeding ulcers, the 30-day death rate was 17 percent in the diabetic group versus just 10 percent in the nondiabetic group, the report indicates. This translates into a 40 percent 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 death rate of 43 percent compared with 24 percent for nondiabetic patients, representing an increased risk of 51 percent.

"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.

SOURCE: Diabetes Care, April 2006.