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Schmeltz, L.R., DeSantis, A.J., Thiyagarajan, V., et al. (2007) Reduction of Surgical Mortality and Morbidity in Diabetic Patients Undergoing Cardiac Surgery with a Combined Intravenous and Subcutaneous Insulin Glucose Management Strategy. Diabetes Care, 30, 823-828.

has been cited by the following article:

• TITLE: Intensive Insulin Therapy Has No Effect on Mortality and Morbidity in Cardiac Surgery Patients: A Meta-Analysis

  AUTHORS: Kedar P. Kulkarni, Ronald S. Chamberlain

  KEYWORDS: Intensive Insulin Therapy, Tight Glycemic Control, Cardiac Surgery, CABG

  JOURNAL NAME: International Journal of Clinical Medicine, Vol.7 No.8, August 3, 2016

  ABSTRACT: Introduction: Optimal glycemic control in cardiac surgery patients remains a laudable but confusing practice. Existing studies have primarily employed two maintenance strategies using either intensive insulin therapy (IIT) (maintain glucose p = 0.628), ICU LOS (MD = -0.073 days, 95% CI = -0.324 to 0.178; p = 0.568), or hospital LOS (MD = 0.269, 95% CI = -2.158 to 2.696; p = 0.828). No difference in AF rates (RR = 0.887, 95% CI = 0.681 to 1.155; p = 0.375) or deep sternal infection (RR = 0.985, 95% CI = 0.357 to 2.720; p = 0.977) were observed. Conclusion: IIT targeting blood sugar levels of 80 - 120 mg/dl have no effect on perioperative outcomes in cardiac surgery patients. IIT is associated with similar mortality, ICU LOS, hospital LOS, AF rates, and deep sternal infection rates compared to more liberal glycemic strategies. IIT should not replace CIT as the standard of care in cardiac surgery patients.