Looks like the end to the long clinical debate – which drug-eluting stent is better: Limus vs Taxol – has finally arrived. A recent analysis published in the Journal of American Medical Association by the American and Indian doctors finally digs into the medical controversy and dishes out evidence-based answers.
Some good news for the diabetic patients. This time it is related to the medical device called drug-eluting stent. A recent analysis conducted by Dr Sripal and colleagues assessed the outcomes, safety and efficacy of everolimus-eluting stent vs a paclitaxel-eluting stent in diabetic patients who underwent percutaneous coronary intervention (PCI).
Over years, the doctors and the clinicians have debated over the efficacy of the two commonly employed drug-eluting stents in diabetic patients who are at increased risk of cardiovascular (CV) events. A drug-eluting stent is a medical device placed in the narrowed or diseased artery where it releases the drug to block further blockage. In most of the cases, the diseased artery is usually the one that supplies blood to the heart, called coronary artery.
Back to the news, let us now talk about the controversy that surrounded the choice of the stent. Because diabetic patients are at an increased risk of cardiovascular events, they often need PCI, commonly called angioplasty. The two main choices of drug-eluting stents in diabetic patients are:
- Everolimus-eluting stent
- Paclitaxel-eluting stent
But What’s The Controversy About The Stents Anyway?
Some studies say that everolimus-eluting stent yields better outcomes in diabetic patients at higher risk of CV events while others bet on the effectiveness of paclitaxel-eluting stent. The controversy is due mainly to the lack of a definitive evidence.
However, we finally have a good piece of evidence – not definitive but convincing. Dr Sripal and co conducted a secondary analysis of the Taxus Element vs Xience Prime in a Diabetic Population (TUXEDO) clinical trial conducted from June 23, 2011-March 12, 2014.
The TUXEDO trial enrolled 1,830 patients. Based on the disease condition, the patients were divided into insulin-treated diabetes mellitus (ITDM) and non-insulin-treated diabetes mellitus (non-ITDM) arms. Both arms were randomized to receive PCI with either everolimus-eluting stent vs a paclitaxel-eluting stent.
Compared to the patients with non-ITDM, the patients with ITDM had an increased incidence of CV events i.e., target vessel failure, myocardial infarction or death secondary to CV disease. As for the choice of drug-eluting stent, patients in the everolimus-eluting stent arm showed an overall reduction in myocardial infarction (1.3%), stent thrombosis (0.5%), target vessel revascularization (1.0%), target vessel failure (3.4%) and major adverse cardiac events (3.9%).
Compared to paclitaxel-eluting stent, everolimus-eluting stent has shown favorable results in diabetic population at heightened risk of CV events.
What Do I Need To Know If I Have Diabetes?
For starters, diabetes is a manageable condition. Sure it has risks, like all other medical conditions, but if managed well, a patient, such as you, can live a long, healthy life with diabetes.
Apart from other measures, controlling blood sugar is extremely important. Doing so is critical for diabetic population because poorly controlled diabetes heightens the risk of a number of diseases, including heart disease, kidney failure, stroke, amputation and loss of eyesight.
Diabetes is a highly prevalent condition. It would not be wrong if we call it one of the most common conditions in the world. Currently, there are more than 422 million people in the world with diabetes.
Among other risks, the CV events stand out and deserve special attention, or let’s say prevention. In fact, they are rather common in people with diabetes. For a healthy functioning heart, you must keep your blood sugar in check.
Tips To Keep Blood Sugar In Control
Do not let the stats scare you. A good blood sugar control is all you need to ensure a healthy life. Despite being prevalent, diabetes is pretty much a manageable condition. Also, there are a number of medicines to assist the blood sugar control.
The American Diabetes Association has outlined some very useful tips for controlling blood sugar. You must follow them if you are looking for a good glycemic control. You should:
- Choose A Healthy Diet: A healthy diet is recommended in everyone but it’s more important in diabetic people. Choose a diet that is balanced and stick to it.
- Exercise Regularly: You must adopt and maintain a healthy lifestyle. Doctors recommend a physical activity of at least 150 minutes per week (30 minutes a day, five days a week).
- Monitor Your Blood Sugar Regularly: Your blood sugar level should be between:
- 70-99 mg/dL – Normal fasting sugar
- < 140 mg/dL – Normal blood sugar level two hours after eating
- Take insulin or other medicines for diabetes, called oral hypoglycemics, on time.
- Visit your general physician regularly.
- Report any symptoms of numbness in the feet, or blurred eye sight to the doctor right away. This may be a sign of diabetes complication.