RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE 28 VOLUME 19 NUMBER 2 • November 2022 Comparably, Pothof et al. stated that patients with IDDM had higher rates of 30-day cerebrovascular infarction and death than those without diabetes (3.4 vs 1.5%; p < 0.001).24 In our series, a more significant rate of mortality and postoperative complications occurred in diabetics being treated with oral antidiabetics, compared to those being treated with insulin, which conflicts other studies that reported a higher frequency of complications in groups on insulin therapy. To some extent, this can be explained by extremely lengthy and irregular therapy of patients on oral antidiabetic agents, which leads to chronic, atherosclerotic changes in the blood vessels. Patients on insulin may be more diligent in their therapy. With regard to long-term regulation of glycaemia, our patients with post-operative complications had significantly higher values of HbA1c (t = 5.010; p < 0.001). Tanashian et al. reported that the presence of DM was associated with an increased risk of ischaemic lesions in the brain and a higher percentage of post-operative complications, associated with increased values of glycaemia (8.0 mmol/l) and HbA1c (7.8–8%) in the pre-operative phase. 25 Dimic et al. stated that the group of diabetics with HbA1c > 7% had a greater cumulative rate of TIA/cerebrovascular infarctions (p = 0.03).22 Parr et al. reported that patients with IDDM, when compared to those with IIDM, had higher rates of cerebrovascular infarction (3.27, 0.93 and 0.94%; p < 0.0001), MI (3.35, 1.10 and 0.87%, p < 0.0001) and hospital mortality (p < 0.0001).26 Jeong et al. have shown that insulin use was associated with a higher rate of mortality and morbidity. The absence of data on serial measurements of HbA1c levels in their analysis was the reason they could not explain differences in glycaemic control.16 It is certain that high concentrations of low-density lipoprotein and chronic hyperglycaemia, indicated by high HbA1c levels, increases the development of atherosclerosis, which sets in earlier and is more pervasive in diabetics. On the basis of the results of our investigation, it is believed that the percentage of post-operative complications may be reduced by means of a better regulation of glycaemia, lower values of HbA1c, prompt diagnosis of glucose intolerance and regular and adequate antidiabetic therapy. Considering the small number of studies that have dealt with this kind of investigation of complications related to diabetes therapy, the hypothesis remains to be proven in similar future randomised studies. Conclusions In comparison to other studies, this research, possibly for the first time, included a large number of patients for a short time period, a high percentage of diabetics were included, the investigation was conducted in diabetics on different types of antidiabetic therapy, and the occurrence of complications was determined according to values of glycosylated haemoglobin. The results of this study indicate that diabetes was an independent risk factor for fatal and non-fatal cardiac or neurological events after CEA since it caused 2.5 times more post-operative complications in the group of diabetic patients. Our study also recorded a higher rate of mortality and post-operative complications, as well as higher HbA1c values in the diabetics on oral antidiabetics than in those on insulin therapy. This was in conflict with similar studies. 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