Surgeons of the medical center of Boston (BMC) found that in diabetes patients with coronary artery bypass graft (CABG) surgery, aggressive Glycemic does not imply a significant improvement in clinical outcomes compared with moderate control. The findings, which will be presented to the 131st annual meeting of the American Surgical Association, also found the incidence of events of hypoglycaemia increased with aggressive blood sugar control.
Currently, 40 per cent of all patients undergoing CABG suffer from diabetes and this number is growing rapidly. Traditionally, these patients have more complications after the surgery, including an increase in the risk of heart attack, infections over the wound and reduces long term survival.
Maintenance of glucose in serum between 120 and 180 mg/dl with infusions of insulin continue to decrease morbidity in diabetic patients with CABG. Previous studies in surgical patients requiring prolonged ventilation suggest that aggressive blood sugar control (less than 120 mg/dl) may improve survival. However, its effect in diabetic patients of CABG is unknown.
Eighty-two diabetic patients undergoing a CABG for the future were divided at random to receive the blood glucose or blood sugar control aggressively facilitated by continuous solutions of insulin intravenously to start from the anesthesia and continue for 18 hours after the surgery.
According to cardiothoracic surgeon of BMC Harold Lazar, MD, author of the presentation, there was no difference in the frequency of adverse effects between the two groups. "Aggressive blood sugar control did not cause a significant improvement in clinical outcomes which can be achieved with moderate control," said Lazar, who is also Professor of surgery at Boston University School of Medicine cardiothoracic "Although the aggressive blood sugar control has increased the incidence of events hipoglucemiano gives as result a higher incidence of neurological events", he adds.
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