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 .
Conventional approach to glucose management for diabetic patients undergoing coronary artery bypass surgery
Continuous insulin infusion was not an effective mode of treatment in maintaining safe blood glucose levels ( < 200 mg/dl ) during the intraoperative period of diabetic patients requiring open-heart surgery . The two modifications investigated to gain better control of the blood glucose were a change in the base solution of the cardioplegia and the use of a sliding insulin scale . Fifty patients including Type I and Type II diabetics were selected for the purpose of this study . The patients were then r and omly divided into two groups categorized by the type of cardioplegic solution administered and the mode of insulin treatment . Group I patients received a dextrose 5%-based cardioplegic solution and blood glucose was treated via continuous intravenous insulin infusion . Group II patients received normal saline 0.9%-based cardioplegic solution and blood glucose was treated via sliding scale .  Blood glucose levels were monitored pre- and postcardio- pulmonary bypass ( CPB ) and every 30 min while on CPB . Glucose values were analyzed by group t test . A p value of < 0.05 was considered statistically significant . When comparing Group I ( mean=258 mg/dl ) with Group II ( mean= 158 mg/dl ) , there was a statistically significant difference between the glucose values at each of the time intervals when the glucose values were recorded . In conclusion , Group II maintained an acceptable blood glucose level ( < 200 mg/dl ) throughout the entire intra- operative period , which suggests that the combination of the sliding insulin scale and modification of the base cardioplegic solution was an effective mode of treatment
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 .