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 .
Intensive Perioperative Glucose Control Does Not Improve Outcomes of Patients Submitted to Open-Heart Surgery: A Randomized Controlled Trial
BACKGROUND : The objective of this study was to investigate the relationship between different target levels of glucose and the clinical outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass . METHODS : We design ed a prospect i ve study in a university hospital where 109 consecutive patients were enrolled during a six-month period . All patients were scheduled for open-heart surgery requiring cardiopulmonary bypass . Patients were r and omly allocated into two groups . One group consisted of 55 patients and had a target glucose level of 80–130 mg/dl , while the other contained 54 patients and had a target glucose level of 160–200 mg/dl . These parameters were controlled during surgery and for 36 hours after surgery in the intensive care unit . Primary outcomes were clinical outcomes , including time of mechanical ventilation , length of stay in the intensive care unit , infection , hypoglycemia , renal or neurological dysfunction , blood transfusion and length of stay in the hospital . The secondary outcome was a combined end-point ( mortality at 30 days , infection or length of stay in the intensive care unit of more than 3 days ) . A p-value of < 0.05 was considered significant . RESULTS : The anthropometric and clinical characteristics of the patients from each group were similar , except for weight and body mass index . The mean glucose level during the protocol period was 126.69 mg/dl in the treated group and 168.21 mg/dl in the control group ( p<0.0016 ) . There were no differences between groups regarding clinical outcomes , including the duration of mechanical ventilation , length of stay in the intensive care unit , blood transfusion , postoperative infection , hypoglycemic event , neurological dysfunction or 30-day mortality ( p>0.05 ) . CONCLUSIONS : In 109 patients undergoing cardiac surgery with cardiopulmonary bypass , both protocol s of glycemic control in an intraoperative setting and in the intensive care unit were found to be safe , easily achieved and not to differentially affect clinical outcomes
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 .