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 .
Preoperative Oral Carbohydrate Administration to ASA III-IV Patients Undergoing Elective Cardiac Surgery
In this study we investigated the effects of preoperative oral carbohydrate administration on postoperative insulin resistance ( PIR ) , gastric fluid volume , preoperative discomfort , and variables of organ dysfunction in ASA physical status III-IV patients undergoing elective cardiac surgery , including those with noninsulin-dependent Type-2 diabetes mellitus . Before surgery , 188 patients were r and omized to receive a clear 12.5 % carbohydrate drink ( CHO ) , flavored water ( placebo ) , or to fast overnight ( control ) . CHO and placebo were treated in double-blind format and received 800 mL of the corresponding beverage in the evening and 400 mL 2 h before surgery . Patients were monitored from induction of general anesthesia until 24 h postoperatively . Exogenous insulin  requirements to control blood glucose levels ≤10.0 mmol/L were used as a marker for PIR . Gastric fluid volume was measured by passive gastric reflux and preoperative discomfort using visual analog scales . Postoperative clinical and surgical data were recorded . Blood glucose levels and insulin requirements did not differ between groups . Patients receiving CHO and placebo were less thirsty compared with controls ( P < 0.01 and P = 0.06 , respectively ) . Ingested liquids did not cause increased gastric fluid volume or other adverse events . The CHO group required less intraoperative inotropic support after initiation of cardiopulmonary bypass weaning ( P < 0.05 ) . In conclusion , preoperative CHO administration before cardiac surgery does not affect PIR . Clear fluids reduce thirst and may be recommended as a safe procedure in ASA III-IV patients . Further research is indicated to investigate possible cardioprotective effects of preoperative CHO intake
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 .