Impaired pain perception in patients with diabetes did not affect ED arrival time in STEMI

CHICAGO — STEMI patients with type 2 diabetes did not visit the ED later than patients without diabetes, although they reported less severe pain and had worse outcomes, according to recent study findings presented here at the ADA Scientific Sessions.

Researcher evaluated 266 patients with first STEMI, 62 with diabetes and 204 without diabetes, to investigate whether there were any differences in hospital arrival time, pain quality and quantity, and the outcome of the index hospitalization between the groups. Researchers hypothesized that patients with diabetes would have worse outcomes due to their impaired pain perception and atypical symptoms.

A modified McGill questionnaire showed that 66% of patients with diabetes reported experiencing slight or no pain, whereas 78% of patients without diabetes described their pain as moderate or severe. The quality of pain for patients with diabetes was mostly described as shortness of breath. In contrast, pain for patients without diabetes was more distinct.

The study indicated that 56% of patients with diabetes arrived within 120 minutes of experiencing symptoms, which was not significantly later than patients without diabetes. However, those with diabetes were less suitable for single-vessel PCI (58% vs. 82%) and more likely to experience in-hospital fatal outcomes while admitted (8.1% vs. 3.4%).

“Earlier arrival times and cautious evaluation of diabetic patients alone are not enough to significantly improve overall survival; a multidisciplinary approach is necessary before neuropathy and irreversible cardiovascular damages set in,” researchers wrote in the abstract. – by Alexandra Todak

For more information:

Gradiser M. #101-LB. Presented at: ADA Scientific Sessions; June 21-25, 2013; Chicago.