Original Article

Acta Diabetologica

, Volume 50, Issue 2, pp 123-128

First online:

Diabetes mellitus and its impact on long-term outcomes after coronary artery bypass graft surgery

  • M. A. M. WitAffiliated withDepartment of Cardiology, Medical Centre Alkmaar
  • , M. de MulderAffiliated withDepartment of Cardiology, Medical Centre Alkmaar
  • , E. K. JansenAffiliated withDepartment of Thoraxsurgery, VU Medical Centre
  • , V. A. W. M. UmansAffiliated withDepartment of Cardiology, Medical Centre Alkmaar Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access


Diabetes mellitus (DM) is an important risk factor for accelerated atherosclerosis and increases cardiovascular disease. Several studies found a higher mortality rate in postoperative diabetic patients than in non-diabetic patients. However, other studies found conflicting evidence on bypass graft dysfunction in patients with diabetes mellitus. We therefore investigated the influence of diabetes mellitus on the long-term outcome after coronary artery bypass surgery (CABG). In this prospective study, 936 consecutive CABG patients were included. These patients were divided into three groups: patients without diabetes mellitus, patients with diabetes mellitus using oral drugs (non-insulin-treated DM) and patients with diabetes mellitus using insulin (insulin-treated DM). The three groups were compared for mortality and (angiographic) bypass graft dysfunction. Of the 936 included patients, 720 (76.8%) patients were non-diabetics, 138 (14.7%) were non-insulin-treated DM, and 78 (8.3%) patients were insulin-treated DM. Follow-up was achieved in all patients, at a mean of 33 months. Mortality was significantly higher in patients with insulin-treated DM, compared with non-insulin-treated DM or non-diabetic patients (P = 0.003). Fourteen (1.5%) patients suffered a myocardial infarction after CABG. A coronary angiography was performed in 77 (8.2%) patients during follow-up, proven bypass graft dysfunction was found in 41 (53.2%) patients. There was no significant difference in bypass graft dysfunction between the three groups. Diabetes mellitus has a significant impact on long-term follow-up after coronary surgery. Particularly insulin dependency is related to an increased mortality. However, diabetes has no influence on angiographically proven bypass graft dysfunction.


Coronary artery bypass graft surgery Diabetes mellitus Mortality Bypass graft dysfunction