Schmitt VH, Hobohm L, Sivanathan V, et al. - In acute pulmonary embolism (PE) cases, an unfavorable clinical patient-profile as well as a higher risk for adverse events, including substantially increased in-hospital mortality, was observed in relation to the presence of diabetes mellitus (DM), this is a fact despite the progress in DM treatments.

• By analyzing the German nationwide inpatient sample of the years 2005-2018, impact of DM on patient-profile and outcome was inquired among 1,174,196 PE patients (53.8% aged≥70years, 53.5% females) in whom 219,550 (18.7%) were diabetics.

• A higher prevalence of cardiovascular risk factors, comorbidities, right ventricular dysfunction (RVD), prolonged in-hospital stay and higher rates of adverse in-hospital events was noted in PE patients with DM.

• Notably, an independent link of DM with elevated in-hospital mortality was found (OR 1.21) post- adjustment for age, gender and comorbidities.

• Diabetics more frequently received systemic thrombolysis (OR 1.18) and DM was related to intracerebral (OR 1.19) as well as gastrointestinal bleeding (OR 1.11).

• A robust risk for shock, RVD, cardiopulmonary resuscitation and in-hospital death (OR 1.75) in PE is conferred by type 1 DM.