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 .
Blood glucose control by a model predictive control algorithm with variable sampling rate versus a routine glucose management protocol in cardiac surgery patients: a randomized controlled trial.
CONTEXT Elevated blood glucose levels occur frequently in the critically ill . Tight glucose control by intensive insulin treatment markedly improves clinical outcome . OBJECTIVE AND DESIGN This is a r and omized controlled trial comparing blood glucose control by a laptop-based model predictive control algorithm with a variable sampling rate [ enhanced model predictive control ( eMPC ) ; version 1.04.03 ] against a routine glucose management protocol ( RMP ) during the peri- and postoperative periods . SETTING The study was performed at the Department of Cardiac Surgery , University Hospital . PATIENTS A total of 60 elective cardiac surgery patients were included in the study . INTERVENTIONS Elective cardiac surgery and treatment with continuous insulin infusion ( eMPC ) or continuous insulin infusion combined with iv insulin boluses ( RMP ) to maintain euglycemia ( target range 4.4 - 6.1 mmol/liter ) were performed . There were 30 patients r and omized for eMPC and 30 for RMP treatment . Blood glucose was measured in 1- to 4-h intervals as requested by each algorithm during surgery and postoperatively over 24 h. MAIN OUTCOME MEASURES Mean blood glucose , percentage of time in target range , and hypoglycemia events were used . RESULTS Mean blood glucose was 6.2 + /- 1.1 mmol/liter in the eMPC vs. 7.2 + /- 1.1 mmol/liter in the RMP group ( P < 0.05 ) ; percentage of time in the target range was 60.4 + /- 22.8 % for the eMPC vs. 27.5 + /- 16.2 % for the RMP group ( P < 0.05 ) . No severe hypoglycemia ( blood glucose < 2.9 mmol/liter ) occurred during the study . Mean insulin infusion rate was 4.7 + /- 3.3 IU/h in the eMPC vs. 2.6 + /- 1.7 IU/h in the RMP group ( P < 0.05 ) . Mean sampling interval was 1.5 + /- 0.3 h in the eMPC vs. 2.1 + /- 0.2 h in the RMP group ( P < 0.05 ) . CONCLUSIONS Compared with RMP , the eMPC algorithm was more effective and comparably safe in maintaining euglycemia in cardiac surgery patients
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 .