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 .
Continuous postoperative blood glucose monitoring and control by artificial pancreas in patients having pancreatic resection: a prospective randomized clinical trial.
OBJECTIVE To evaluate a closed-loop system providing continuous monitoring and strict control of perioperative blood glucose following pancreatic resection . DESIGN Prospect i ve , r and omized clinical trial . PATIENTS Thirty patients who had pancreatic resection for pancreatic neoplasm . INTERVENTIONS Patients were prospect ively r and omized . Perioperative blood glucose levels  were continuously monitored using an artificial endocrine pancreas ( STG-22 ) . Glucose levels were controlled using either the sliding scale method ( sliding scale group , n = 13 ) or the artificial pancreas ( artificial pancreas group , n = 17 ) . MAIN OUTCOME MEASURES Incidence of severe hypoglycemia ( < 40 mg/dL ) during the intensive care period following pancreatic resection in patients monitored with the artificial pancreas . The secondary outcome measure was the total amount of insulin required for glycemic control in the first 18 hours after pancreatic resection in each patient group . RESULTS In the sliding scale group , postoperative blood glucose levels rose initially before reaching a plateau of approximately 200 mg/dL between 4 and 6 hours after pancreatectomy . The levels remained high for 18 hours postoperatively . In the artificial pancreas group , blood glucose levels reduced steadily , reaching the target zone ( 80 - 110 mg/dL ) by 6 hours after surgery . The total insulin dose administered per patient during the first postoperative 18 hours was significantly higher in the artificial pancreas group ( mean [ SD ] , 107 [ 109 ] IU ) than the sliding scale group ( 8 [ 6 ] IU ; P < .01 ) . Neither group showed hypoglycemia . CONCLUSIONS Perioperative use of an artificial endocrine pancreas to control pancreatogenic diabetes after pancreatic resection is an easy and effective way to maintain near-normal blood glucose levels . The artificial pancreas shows promise for use as insulin treatment for patients with pancreatogenic diabetes after pancreatic resection
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 .