title: Continuous insulin infusion is associated with a reduced post-surgical length of stay, but not with the complication rate, in patients with diabetes mellitus undergoing coronary artery bypass graft.
abstract: OBJECTIVE
  To establish if glucose management with continuous intravenous insulin infusion (CII) in the early post-operative period after coronary artery bypass graft (CABG) surgery is associated with complication rate and length of hospital stay (LOS) in patients with diabetes mellitus (DM).
  
  
  METHODS
  We reviewed the records of 587 patients with DM who underwent CABG from January 1999 until January 2008; 316 patients were placed on CII, while 271 patients were treated with subcutaneous insulin. We examined patient age, glycated hemoglobin (HgbA1c), 24- and 72-h post-operative average capillary blood glucose (CBG), length of stay (LOS), and the rate of complications.
  
  
  RESULTS
  There was no difference in HgbA1c between the groups. Mean CBG values at both 24 h and 72 h remained the same in the CII group (167 mg/dl), while in the non-CII group they were 194 mg/dl and 189 mg/dl, respectively (p<0.001 between the groups). Post-surgical median LOS was 6 days in the CII group and 6.5 days in the non-CII group (p=0.003). Complications occurred at similar rate (in 10% and 11% of patients) in the two groups.
  
  
  CONCLUSIONS
  CII is associated with a reduced post-surgical LOS in patients with DM who undergo CABG.
authors.affiliation: Division of Endocrinology and Metabolism and Friedman Diabetes Institute, Beth Israel Medical Center, New York, New York 10003, USA.
authors.forename: Z
authors.initials: Z
authors.lastname: Abelev
authors.forename: A
authors.initials: A
authors.lastname: Seth
authors.forename: R
authors.initials: R
authors.lastname: Patel
authors.forename: S
authors.initials: S
authors.lastname: Goldstein
authors.forename: M
authors.initials: M
authors.lastname: Bogun
authors.forename: M
authors.initials: M
authors.lastname: Paliou
authors.forename: J
authors.initials: J
authors.lastname: Schlosser
authors.forename: P
authors.initials: P
authors.lastname: Homel
authors.forename: A
authors.initials: A
authors.lastname: Busta
authors.forename: D
authors.initials: D
authors.lastname: Seto-Young
authors.forename: R
authors.initials: R
authors.lastname: Tranbaugh
authors.forename: L
authors.initials: L
authors.lastname: Poretsky
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin