Survival in Diabetics Undergoing Bypass Not Improved by Aggressive Glycemic Control

A new study has found that aggressive glycemic control does not improve survival in diabetic patients undergoing coronary artery bypass graft (CABG) surgery as compared with moderate control. The report by Surgeons from Boston Medical Center (BMC) also found the incidence of hypoglycemic events increased with aggressive glycemic control.

Currently, 40 percent of all patients undergoing CABG suffer from diabetes, and this number is quickly rising. Traditionally these patients have more complications following surgery, including greater risk of heart attacks, more wound infections and reduced long-term survival.

In the study, eighty-two diabetic patients undergoing CABG were prospectively randomized to receive either aggressive glycemic control or moderate glycemic control using continuous intravenous insulin solutions beginning at anesthesia and continuing for 18 hours after surgery.

Researchers found that there was no difference in the incidence of major adverse effects between the two groups.

"Aggressive glycemic control did not result in any significant improvement of clinical outcomes than can be achieved with moderate control," said Lazar, who is also a professor of cardiothoracic surgery at Boston University School of Medicine.

"Although aggressive glycemic control did increase the incidence of hypoglycemic events, it did not result in an increased incidence of neurological events," he added.

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The study has been published in the journal Annals of Surgery.

Source-ANI