title: Prevalence and Determinants of Glycemic Abnormalities in Cardiac Surgery Patients without a History of Diabetes: A Prospective Study.
abstract: OBJECTIVE
  To evaluate the prevalence and persistence of postoperative glycemic abnormalities in patients without a history of diabetes, undergoing cardiac surgery (CS).
  
  
  METHODS
  Ninety-two patients without diabetes with planned elective CS procedures at a tertiary institution were evaluated preoperatively and 3 months postoperatively for measures of glucose control including hemoglobin A1c, fasting plasma glucose, 2-h post oral glucose load, and insulin levels. Data from the hospital course were recorded.
  
  
  RESULTS
  Valid data were available from 61 participants at 3 months; 59% had prediabetes and 10% had diabetes preoperatively by one or more diagnostic criteria and continued to be dysglycemic at 3 months. Preoperative A1C was an independent predictor of postoperative hyperglycemia (p = 0.02). Insulin resistance and BMI rather than glycemic abnormalities before surgery were associated with a longer duration of the postoperative insulin infusion (p = 0.004, p = 0.048).
  
  
  CONCLUSIONS
  Seventy percent of CS patients without known diabetes met criteria for diabetes or prediabetes preoperatively, and these abnormalities persisted after surgery.
authors: Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan , Ann Arbor, MI , USA.
authors: Roma Y
authors: RY
authors: Gianchandani
authors: Ann Arbor Endocrinology and Diabetes Associates, PC , Ypsilanti, MI , USA.
authors: Sima
authors: S
authors: Saberi
authors: Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan , Ann Arbor, MI , USA.
authors: Preethi
authors: P
authors: Patil
authors: Department of Cardiac Surgery, University of Michigan , Ann Arbor, MI , USA.
authors: Richard L
authors: RL
authors: Prager
authors: Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan , Ann Arbor, MI , USA.
authors: Rodica
authors: R
authors: Pop-Busui
keywords: A1c; cardiovascular surgery; diabetes mellitus; hyperglycemia; insulin resistance; prediabetes