Impact of Perioperative Glycemic Control Strategy on Patient Survival After Coronary Bypass Surgery

Perioperative Hyperglycemia Management

“…However, the strict glucose control group took longer to reach target range, had a greater number of measurements outside of the target range, and more patients with hypoglycemic events. Pezzella et al 44 assessed the long-term mortality in diabetics and non-diabetics randomized to intensive versus conventional control. There was no difference in health-related quality of life or survival between groups over a 40-month follow-up period demonstrating that long-term outcomes were not worse when blood glucose was maintained in liberal target range.…”

Optimal Glycemic Control in Hospitalized Patients

“…3,5,[9][10][11][12][13][14][15][16][17][18] Early, heterogeneous studies suggested that intensive treatment of hyperglycemia improved hospital outcomes, 3,12,13 which led to recommendations for intensive insulin therapy and glycemic targets of less than 110 mg/dL for some patient populations. Additional trials in critically ill patients failed to demonstrate a significant improvement …”

Can the onset of heart failure be delayed by treating diabetic cardiomyopathy?

“…According to recent recommendations, the glycaemia should not exceed 180 mg/dL (10 mmol/L) during the perioperative period [44]. There is proof that a strict glycaemic control (90–120 mg/dL), in patients after CABG, does not improve the survival [45]. On the other hand, some investigators found the intensive insulinotherapy to improve cardiac output after CABG [46].…”