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 .
A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study
Purpose An optimal target for glucose control in ICU patients remains unclear . This prospect i ve r and omized controlled trial compared the effects on ICU mortality of intensive insulin therapy ( IIT ) with an intermediate glucose control . Methods Adult patients admitted to the 21 participating medico-surgical ICUs were r and omized to group 1 ( target BG 7.8–10.0 mmol/L ) or to group 2 ( target BG 4.4–6.1 mmol/L )  . Results While the required sample size was 1,750 per group , the trial was stopped early due to a high rate of unintended protocol violations . From 1,101 admissions , the outcomes of 542 patients assigned to group 1 and 536 of group 2 were analysed . The groups were well balanced . BG levels averaged in group 1 8.0 mmol/L ( IQR 7.1–9.0 ) ( median of all values ) and 7.7 mmol/L ( IQR 6.7–8.8 ) ( median of morning BG ) versus 6.5 mmol/L ( IQR 6.0–7.2 ) and 6.1 mmol/L ( IQR 5.5–6.8 ) for group 2 ( p < 0.0001 for both comparisons ) . The percentage of patients treated with insulin averaged 66.2 and 96.3 % , respectively . Proportion of time spent in target BG was similar , averaging 39.5 % and 45.1 % ( median ( IQR ) 34.3 ( 18.5–50.0 ) and 39.3 (26.2–53.6)% ) in the groups 1 and 2 , respectively . The rate of hypoglycaemia was higher in the group 2 ( 8.7 % ) than in group 1 ( 2.7 % , p < 0.0001 ) . ICU mortality was similar in the two groups ( 15.3 vs. 17.2 % ) . Conclusions In this prematurely stopped and therefore underpowered study , there was a lack of clinical benefit of intensive insulin therapy ( target 4.4–6.1 mmol/L ) , associated with an increased incidence of hypoglycaemia , as compared to a 7.8–10.0 mmol/L target . ( Clinical Trials.gov # NCT00107601 , EUDRA-CT Number : 200400391440 )
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 .