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 .
Intensive Versus Conventional Insulin Therapy in Type 2 Diabetes Patients Undergoing D2 Gastrectomy for Gastric Cancer: A Randomized Controlled Trial
Background This study was to compare the effect of intensive insulin therapy ( IIT ) to conventional insulin therapy ( CIT ) on postoperative outcomes among type 2 diabetes mellitus ( DM ) patients who underwent D2 gastrectomy for gastric cancer . Methods We r and omly assigned gastric cancer patients with type 2 DM who underwent radical gastrectomy to receive  IIT ( maintenance of blood glucose at a level between 4.4 and 6.1 mmol/l ) with insulin infusion or CIT ( maintenance of blood glucose at a level between 10 and 11.1 mmol/l ) during the postoperative period . Results Of the 179 eligible patients , 92 patients were assigned to receive IIT and 87 patients to receive  CIT . Mean blood glucose concentrations were lower in the intensive group ( IG ) than in the conventional group ( CG ) ( 5.5 ± 0.8 vs. 9.9 ± 1.0 mmol/l , P < 0.001 ) . Hypoglycemia occurred in 6 patients ( 6.5 % ) in the IG ( P = 0.029 ) versus in 1 patient ( 1.1 % ) in the CG . Hospital mortality did not differ significantly between two groups ( 4.3 % vs. 5.7 % , P = 0.742 ) . However , IIT significantly reduced morbidity ( from 18.4 to 7.6 % , P = 0.031 ) . Also , IIT shortened the days to suture removal , postoperative hospital stay , and postoperative duration of antibiotic use . The HOMA-IR score was lower at all time points in IG . Moreover , IIT increased the postoperative HLA-DR expression on monocytes on postoperative days 3 and 5 . Conclusions IIT significantly reduced short-term morbidity but not mortality among type 2 DM patients who underwent D2 gastrectomy for gastric cancer . Furthermore , a possible mechanism of suppression of the insulin resistance and improvement of HLA-DR expression may partially explain the benefits of IIT
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 .