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Published on: March 27, 2018
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Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and
Harold L Lazar1, Stuart R Chipkin, Carmel A Fitzgerald
1Department of Cardiothoracic Surgery, Boston University School of Medicine and Boston Medical Center, 88 E Newton St, B402, Boston, Mass 02118, USA. harold.lazar@bmc.org
Circulation
|March 10, 2004
Summary
Tight glycemic control using glucose-insulin-potassium (GIK) solution in diabetic coronary artery bypass graft (CABG) patients significantly improved perioperative outcomes. This intervention led to better survival rates and fewer complications like atrial fibrillation and wound infections.
Area of Science:
- Cardiology
- Endocrinology
- Surgical Outcomes
Background:
- Diabetic patients undergoing coronary artery bypass graft (CABG) surgery face increased perioperative risks.
- Optimizing glycemic control in this population is crucial for improving outcomes.
Purpose of the Study:
- To evaluate the efficacy of tight glycemic control using a modified glucose-insulin-potassium (GIK) solution in diabetic CABG patients.
- To assess the impact of GIK on perioperative outcomes, survival, and complication rates.
Main Methods:
- A prospective randomized study involving 141 diabetic CABG patients.
- Intervention group received tight glycemic control (serum glucose 125-200 mg/dL) with GIK solution.
- Control group received standard therapy (serum glucose <250 mg/dL) with subcutaneous insulin.
Main Results:
- GIK group achieved significantly lower serum glucose levels (138+/-4 vs 260+/-6 mg/dL, P<0.0001).
- Reduced incidence of atrial fibrillation (16.6% vs 42%, P=0.0017) and shorter hospital stay (6.5 vs 9.2 days, P=0.003).
- Improved 2-year survival (P=0.04), decreased recurrent ischemia (5% vs 19%, P=0.01), and fewer wound infections (1% vs 10%, P=0.03).
Conclusions:
- Tight glycemic control with GIK solution is beneficial for diabetic CABG patients.
- Improves perioperative results, enhances long-term survival, and reduces ischemic and wound complications.
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