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 .
Comparison of a continuous glucose-insulin-potassium infusion versus intermittent bolus application of insulin on perioperative glucose control and hormone status in insulin-treated type 2 diabetics.
STUDY OBJECTIVE To compare the effect of two different perioperative insulin management regimes on patients undergoing either major surgery ( vascular surgery ) or minor surgery ( vitrectomy ) .  DESIGN Prospect i ve , double-blind r and omized trial . PATIENTS 48 insulin-treated type 2 diabetics aged 18 to 85 years were studied . SETTING University medical center . INTERVENTIONS Patients were divided into four groups of 12 patients each : Groups A and B ( major surgery ) , Groups C and D ( minor surgery ) . Group A and C patients were treated with a continuous modified glucose-insulin-potassium infusion according to blood glucose levels after intubation . Patients assigned to Groups B and D were treated with intermittent intravenous ( IV ) insulin injections when glucose levels exceeded 12 mmol L(-1 ) . MEASUREMENTS Glucose and potassium levels were measured every 15 minutes and 30 minutes during surgery and up to 4 hours post-surgery . Plasma levels of lactate , cortisol , glycerol , and free fatty acids were measured in arterial sample s after intubation ( S1 ) , after extubation ( S2 ) , and 4 hours after surgery ( S3 ) . MAIN RESULTS There were no significant differences of the patient characteristics among the four groups . There was no significant difference in the time course of plasma glucose levels and hormone variables measured among the four groups . One episode of hyperglycemia in Group D during the postoperative period was treated with 12 IV units of insulin . One patient in Group A and one in Group B received  potassium  intraoperatively ( 15 and 29 mmoL , respectively ) . Postoperatively , two other patients of Group A received 19 and 12,5 mmoL , respectively , and one of Group B received 20 mmoL potassium . CONCLUSIONS Both regimens result ed in relatively stable and comparable blood glucose levels throughout the perioperative period of the minor and major surgeries without differences in metabolic control as measured by levels of lactate , cortisol , glycerol and free fatty acids . Simplicity would favor the intermittent regimen to manage insulin treated type 2 diabetics
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 .