People with diabetes are more likely to develop coronary artery disease than people without it, and the disease tends to be more widespread. That has practical consequences. When blocked arteries need treatment, the option recommended for people with diabetes is often different from the one recommended for others.
Why diabetes affects the heart arteries differently
High blood sugar gradually damages blood vessel walls and encourages fatty deposits to build up. In people with diabetes, these deposits often affect multiple arteries, extend along longer sections and involve smaller branches.ย
Diabetes can also reduce the usual warning signs of heart disease. Some people develop serious blockages without chest pain. A doctor should therefore check for breathlessness or unusual tiredness during physical activity.
Stents or bypass?
Doctors can normalise blood flow to the heart through angioplasty or coronary artery bypass grafting (CABG). During angioplasty, a small balloon widens the narrowed artery, and a stent is usually placed to keep it open. CABG takes a different approach: the surgeon uses a blood vessel, often an artery from the chest wall, to create a new route for blood to flow past the blockage.
For people with diabetes and disease in several coronary arteries, large clinical trials have found that bypass surgery led to lower rates of death and heart attack over the following years compared with stenting. This is why international guidelines generally favour bypass for this group, though every decision depends on the individual’s anatomy, other health conditions and preferences.
Stents are a good option in many situations, including emergencies and simpler disease patterns. The point is not that one treatment is always better, but that diabetes shifts the balance.
Who makes the decision?
Guidelines recommend that the choice is made by a heart team, typically a cardiologist and a cardiac surgeon reviewing the angiogram together. Patients should be included in the discussion and have time to ask questions.
Arteries or veins?
Surgeons can use different blood vessels as bypass grafts. An artery from inside the chest wall, called the internal mammary or internal thoracic artery, is usually connected to the most important coronary artery at the front of the heart, because these arterial grafts tend to stay open for many years. Veins taken from the leg and arteries from the arm are also used for additional bypasses. Your surgeon will explain which grafts are planned and why.
Preparing for surgery with diabetes
Controlling blood sugar before the operation helps wounds heal and reduces infections. Your doctor may change your diabetes medication before surgery. You may need to stop taking medication for a few days, depending on the medicine and your condition. Insulin is used temporarily in hospital to keep levels stable.
Recovery
Most patients spend a day or two in intensive care and about a week in hospital after conventional bypass surgery. The breastbone takes six to eight weeks to heal. Cardiac rehabilitation, a supervised programme of exercise and education, improves recovery and is strongly recommended. Wounds need careful attention in people with diabetes, especially leg wounds where a vein was taken.
The long-term picture
Bypass surgery normalises blood flow to the heart, but it does not stop coronary artery disease from progressing. Blood sugar, high blood pressure and cholesterol need to be under control. Avoiding smoking and staying physically active also help protect the heart. Your doctor may prescribe newer diabetes medicines that offer added protection for the heart and kidneys.
Choosing the right cardiology hospital
Searching for the best hospital in Dubai is a natural first step. For a patient with diabetes facing heart surgery, though, the more useful question is whether cardiac surgery, cardiology, endocrinology and rehabilitation are available together, so that diabetes is managed as part of the surgical plan rather than separately.
Where is bypass surgery performed in Dubai?
Aster Hospitals, a multispeciality hospital group in Dubai with sites including Mankhool, Al Qusais, Muhaisnah and Jebel Ali, provides Coronary Artery Bypass Surgery in Dubai through its cardiothoracic team.ย
According to the group, single- or double-vessel coronary disease can also be treated with minimally invasive bypass in suitable patients. Endocrinology specialists work at its hospitals, and post-surgery rehabilitation plans and a cardiac rehabilitation programme support patients after discharge.
For people with diabetes, bypass surgery may offer better long-term outcomes when several coronary arteries are blocked. Recovery also depends on keeping blood sugar under control, taking prescribed medicines and attending cardiac rehabilitation. Discussing the benefits and risks with your cardiologist and cardiac surgeon helps you choose a treatment that suits your condition and long-term health needs.
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