Any Insulin dependent diabetics out there, who had elective stent intervention?

[WardijaWardija]

Anyone out there who is a insulin dependent diabetic and have had a stent/s fitted as a routine elective treatment, i.e not as a result of a heart attack/emergency ?

This is my situation and I'm having 3 stents inserted on 22.7.19

Obviously, given that my arteries are significantly blocked, and the fact that I have not always been fully insulin compliant over the last 25 years, I hold my hands up to contributing to my own demise. That said, I did change my ways, albeit later rather than sooner, and of course not scott free, having severe neuropathy and renal issues. But I still find it a huge challenge to stay on track - as my life does not revolve around a routine. It is still a daily challenge to manage my diabetes and feel like such a failure.

Would just like to know if there is anybody out there who is, or has been in a similar scenario, just for support please.

[MichaelJH Heart Star]

There are a number of insulin dependent diabetics on the forum with various heart conditions. I suspect at over fifty years I may be the longest service (the Order of the Golden Syringe). Last year I had a quadruple bypass. Originally stents were planned but the calcification was too severe. Initially diabetes was blamed (it always is) but my cardiologist agreed with me that it was probably due to a horrific family history (my father, his brother and their father all dying prematurely from heart attacks) with the diabetes just complicating things. Post your stents it will be much the same medication as post bypass; stains started or increased to prevent restenosis, probably a beta blocker to reduce strain in the heart, possibly another BP medication and aspirin or another blood thinning/anti-coagulant drug.

For now it is just a question of being as fit as you can and keeping those BGs in range for a good HbA1c. Good luck!

[WardijaWardija in reply to MichaelJH]

Thanks Michael for your reply. Diabetes is no fun eh . . .

My current medication is: Omeprazole 40mgs, Perindopril 2mgs, Asprin 75mgs and Atorvastatin 20mgs.

I'm guessing that the doses will be increased.

Just as an aside, Initially after a recent angiogram and a "botched" attempt to put a stent in (with zero sedation)

I was referred over to surgical cardiology and scheduled for a quadruple bypass. I thought my life was over, I was devastated - to the point of refusing the surgery, it was that bad, at least for me.

However, when I met the appointed surgeon, nice as he was, he refused to carry out the bypass surgery as he said that it was too high risk, considering my diabetes and other medical issues, including the fact that I had a stroke last year. He basically said there was too high a risk that I wouldn't survive the duration of the operation.

I'm aware that bypass surgery is the generally preferred option for diabetics and not stent's which have more side effects and a higher chance of having heart attacks and strokes thereafter.

So I have to conclude that the surgeon must have been seriously concerned as to the possible outcome.

On a brighter front, at least this way I will have a chance of prolonging my life at least for a while and I'm happy to say that this particular surgeon, who only does critical heart surgeries, has agreed, in my case to do my stents himself and I'll be under a full general anesthetic.

I must have a guardian angel out there somewhere, having gone from total despair to having hope. I feel truly blessed.

I'll take your good advice on board and do my very best.

Thank you and have a wonderful day.

[MichaelJH Heart Star in reply to WardijaWardija]

My main additional risk in addition to the diabetes was PAD (peripheral arterial disease) particularly in the left leg. A clot could cause serious problems including loss of the limb (you may have seen the result of Gary Mabbutt's leg attack!). Because of my surgeon's long list I changed surgeons. I met the new one beforehand and we had a frank and detailed discussion about the risk factors and various options. He had a plan for all eventualities. Whilst my surgery took longer than average and I needed a transfusion (not Guinness unfortunately) I came round on just a drip and heart monitoring.

Medication wise the isosorbide mononitrate (for angina) was removed, lisinopril reduced, Bisoprolol added, Atorvastatin quadrupled, and Omeprazole and aspirin left as is. In hospital I was also on anticoagulants. I suspect your medication changes may be similar particularly the Atorvastatin to prevent any restenosis. The dreaded "sliding scale" caused a few issues until I started doing my own BGs and insulin.