Study Examines Treatment Options for Patients with Diabetes and Heart Disease

The University of Texas Medical School at Houston is one of 42 sites where researchers are studying how best to improve outcomes for patients who have diabetes and heart disease. Nearly 3,000 patients nationwide for the multicenter, randomized trial, known as BARI 2D, are being recruited.

The study will examine whether surgical or catheter-based procedures to reopen clogged arteries, combined with aggressive medical therapy, is more effective in lowering a patient’s five-year mortality rate than medical therapy alone.

"Atherosclerosis develops more quickly and tends to be more severe in those with diabetes, and we don’t have a well-established protocol for treating these patients," said Francisco Fuentes, M.D., professor of cardiology at UT-Houston. "We need to determine the best strategy for treatment."

Type II diabetes mellitus, which is becoming more prevalent, is one of the most significant risk factors for coronary artery disease and consequent mortality. There is evidence that bypass surgery in patients with Type II diabetes reduces their mortality rate more so than catheterization procedures, Fuentes said. However, the jury is still out on whether medical therapy alone is enough, and there are continuing advancements in catheterization techniques.

In addition to looking at surgery and catheter-based therapies, researchers will examine whether insulin-providing drugs or insulin-sensitizing medications increase the effectiveness of other techniques in prevention of heart attacks and death from coronary artery disease.

Fuentes, along with Victor Lavis, M.D., professor of endocrinology, will recruit 60 patients over the next two years at UT-Houston and monitor them for five years.

– Meredith Raine-Middleton

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©2006 Texas Medical Center

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