None of the trials examined the effects of the interventions in terms of costs .
AUTHORS ' CONCLUSIONS The included trials did not demonstrate significant differences for most of the outcomes when targeting intensive perioperative glycaemic control compared with conventional glycaemic control in patients with diabetes mellitus .
However , posthoc analysis indicated that intensive glycaemic control was associated with an increased number of patients experiencing hypoglycaemic episodes .
BACKGROUND Patients with diabetes mellitus are at increased risk of postoperative complications .
Data from r and omised clinical trials and meta-analyses point to a potential benefit of intensive glycaemic control , targeting near-normal blood glucose , in patients with hyperglycaemia ( with and without diabetes mellitus ) being su bmi tted to surgical procedures .
However , there is limited evidence concerning this question in patients with diabetes mellitus undergoing surgery .
OBJECTIVES To assess the effects of perioperative glycaemic control for diabetic patients undergoing surgery .
[Perioperative management of the diabetic patient in cardiac surgery with extracorporeal circulation].
The hyperglycemia usually observed in patients undergoing heart surgery with extracorporeal circulation ( EC ) represents a difficult therapeutic problem . We studied the effects of several regimens of insulin therapy on serum glucose ( SG ) in 24 noninsulin dependent diabetic patients ( NIDDs ) . The patients were r and omly divided in five groups ; group A received on IV bolus of 10.0 - 50.0 U/h according to glycosuria ; groups B , C , D and E were given a continuous iv insulin infusion of 2.5 , 5.0 , 7.5 and 10.0 U/h respectively . In 10 non-diabetic patients ( NDP )  SG levels were also measured , but insulin was not given . A mean of 5.0 l/m2 of body surface of fluids containing 300 g of glucose were administered to all patients during surgery . At the operations SG levels rose progressively soon after the anesthesia was started , reached the highest values during the period of EC , and decreased slowly in blood sample s taken after the EC phase and by 24h . This patterns was shown by all groups studied statistically significant lower SG levels , however , were observed in patients of group C , whose values were similar to those seen in the NDP group . Groups D and E had slightly higher SG levels than those of group C. An additional NIDDM patient with advanced chronic renal failure ( CRF ) , had a tendency to hypoglycemia even during the EC period in response to relatively low doses of insulin ( 2.5 U/h ) , given by a continuous iv infusion and , although the insulin administration was stopped , his SG levels remained well below the mean values of the other patients for the rest of the operation . ( ABSTRACT TRUNCATED AT 250 WORDS
None of the trials examined the effects of the interventions in terms of costs .
AUTHORS ' CONCLUSIONS The included trials did not demonstrate significant differences for most of the outcomes when targeting intensive perioperative glycaemic control compared with conventional glycaemic control in patients with diabetes mellitus .
However , posthoc analysis indicated that intensive glycaemic control was associated with an increased number of patients experiencing hypoglycaemic episodes .
BACKGROUND Patients with diabetes mellitus are at increased risk of postoperative complications .
Data from r and omised clinical trials and meta-analyses point to a potential benefit of intensive glycaemic control , targeting near-normal blood glucose , in patients with hyperglycaemia ( with and without diabetes mellitus ) being su bmi tted to surgical procedures .
However , there is limited evidence concerning this question in patients with diabetes mellitus undergoing surgery .
OBJECTIVES To assess the effects of perioperative glycaemic control for diabetic patients undergoing surgery .