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 .
Insulin glargine improves glycaemic control after coronary surgery in patients with diabetes or pre-diabetes
Objectives . Determine if pre-emptive daily insulin glargine surpasses regular insulin when needed for glycaemic control after cardiac surgery . Design . Prospect i ve , r and omized study of 43 patients ( scheduled for coronary artery bypass grafting ) with preoperatively diagnosed diabetes ( DM ) or pre-DM . Lantus group received insulin glargine daily from start of surgery while Actrapid group received regular insulin ( sliding scale ) when needed ( plasma glucose ( P-glu ) > 10 mmol/l ) . Primary endpoint was percent of pre- and post-pr and ial P-glu values within Target Intervals : Pre-pr and ial P-glu : 4.5–7 mmol/l ; post-pr and ial P-glu : 4.5–9 mmol/l . Study period 1–4 days after surgery . Tissue glucose was also measured continuously . Results . More than twice as many P-glu values were within Target Interval for Lantus patients as compared with Actrapid patients ( p < 0.001 ) . One of 504 timed measurements was < 4 mmol/l . Area under the curve for glucose > 7 mmol/l was reduced by 61 % by Lantus ( p < 0.001 ) . Conclusion . The routine protocol with pre-emptive glargine insulin studied here provides a major improvement in glycaemic control with a minimal incidence of hypoglycaemia and without an excessive increase in nursing burden
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 .