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 .
Glucose-insulin-potassium solutions improve outcomes in diabetics who have coronary artery operations.
BACKGROUND This study was undertaken to determine whether glucose-insulin-potassium ( GIK ) would improve myocardial performance and limit morbidity after coronary artery bypass grafting in diabetic patients . METHODS Forty consecutive coronary artery bypass grafting patients with medically treated diabetes mellitus were prospect ively r and omly assigned to either a GIK group ( n = 20 ; 500 mL D5W + 80 U regular insulin + 40 mEq KCl 30 mL/hour ) or a no-GIK group ( n = 20 ; D5W at 30 mL/hour ) . The GIK was begun at anesthetic induction and continued for 12 hours postoperatively . RESULTS Patients treated with GIK had higher postoperative cardiac indices ( 2.88 + /- 0.50 versus 2.20 + /- 0.39 L/minute per square meter ; p < 0.0001 ) , lower inotrope scores ( 0.40 + /- 0.68 versus 1.25 + /- 1.44 ; p = 0.05 ) , less weight gain ( 5.80 + /- 3.76 versus 13.85 + /- 6.52 pounds ; p < 0.0001 ) , and had shorter times of ventilator support ( 8.35 + /- 2.60 versus 13.45 + /- 7.33 hours ; p = 0.0128 ) . They had a significantly lower prevalence of atrial fibrillation ( 15 % versus 60 % ; p = 0.003 ) , and shorter hospital stays ( 6.70 + /- 1.52 versus 10.15 + /- 6.62 days ; p = 0.02 ) . CONCLUSIONS Substrate enhancement with GIK in diabetic patients improved myocardial performance and result ed in faster recovery after coronary artery bypass grafting
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 .