A new study has revealed that inadequate blood sugar control in patients having heart surgery can quadruple post-surgery death and major complications, irrespective of whether the patient is a diabetic or not.
The study led by researchers from University of Bristol has shown that disturbed blood sugar control occurred not only in known diabetics, but that more than half of heart patients who developed moderate to poor blood sugar control post-surgery were not thought to be diabetic.
Diabetes has long been associated with a poor clinical outcome following heart surgery and there have been a number of advances in operative and intensive care techniques for diabetic heart patients.
These findings have new and major implications for the treatment of heart patients as they suggest that inadequate control of blood sugar rrespective of diabetes mellitus is associated with four-fold increase of in-hospital mortality and major complications including heart attack (2.7 fold increase), neurological, kidney, lung and gastrointestinal injury.
Lead researcher Dr Raimondo Ascione, Reader and Consultant in Cardiac Surgery at the Bristol Heart Institute, insists that surgeons and intensive care specialists to use strict protocols of active blood sugar control in all patients admitted for major surgery.
"Currently, the absence of recognised guidelines is creating confusion on how to face the challenge of clinical conditions other than diabetes leading to derangement of glucose metabolism. The lack of rigorous research in this field does not help," said Ascione.
"Important clinical decisions are often left to the individual clinician. These include: which screening tests, if any, to use on admission; whether or not to use a blood glucose control strategy during hospital stay, which level of blood glucose to target, and whether this targeting has to be strict or lenient.
"We believe that the findings of our study might apply also to all those non-cardiac surgery patients admitted for any other major surgical procedure worldwide.
"This might have serious implications for patients life expectancy and place an enormous burden on hospital resources," Ascione added.
"This research provides the basis for further, in depth studies to try to understand how better sugar control can help save more lives during and after heart surgery," said Professor Peter Weissberg, Medical Director of the BHF, who co-funded the study.