title: Insulin infusion on postoperative complications of coronary artery bypass graft in patients with diabetes mellitus.
abstract: BACKGROUND
  Cardiovascular events are common in patients with diabetes mellitus (DM), which make coronary artery bypass graft (CABG) a highly demanded surgery in this population. Tight control of blood glucose in patients with DM is beneficial in reducing postoperative complications; however, the adequate range has not been determined yet.
  
  
  OBJECTIVE
  This study aimed to investigate the effect of semi-tight (moderate) control of DM on complications and serum glucose levels during and after CABG.
  
  
  METHODS
  In this prospective clinical trial, 18 and 31 patients with and without DM, respectively, who were referred to Shahid Chamran Hospital, Isfahan, Iran, for elective CABG surgery, were enrolled. For DM group, patients with controlled DM (i.e. glycosylated hemoglobin levels [HgA1C] ≤ 7%) were recruited. Blood glucose level (blood sugar, BS) was measured after anesthesia, during pumping, warming, off pumping, six and 12 hours after Intensive Care Unit (ICU) admission, and at discharging from the hospital. The hemodynamic state of the patients, bleeding, need of blood transfusion, infection, and duration of hospitalization were also monitored and recorded.
  
  
  RESULTS
  None of the BS measurements (FBS, after anesthesia, on-pump, warming, off pump, six and 12 hours after ICU admission, and at discharge) were significantly different between study groups (P > 0.05). Frequency of surgery site bleeding and blood transfusion need were not significantly different between these groups (P > 0.05).
  
  
  CONCLUSIONS
  Semi-tight control of DM with insulin infusion during operation did not led to any difference in the type and rate of CABG complications between patients with well-controlled and those without DM; however, BS levels in patients with well-controlled DM could be more easily controlled.
authors.affiliation: Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Masoumi
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Frasatkhish
authors.affiliation: Department of Cardiac Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Bigdelian
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ziyaefard
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Sadeghpour-Tabae
authors.affiliation: Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Mansouri
authors.affiliation: Department of Anesthesiology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Jalali
keywords: Coronary Artery Bypass Graft; Glucose; Insulin; Surgery