Comparing Effects of Continuous Insulin Infusion with or without Subcutaneous Glargine Insulin on Glycemic Control in Diabetic Patients Undergoing Coronary Artery Bypass Graft (CABG)

OBJECTIVE: Hyperglycemia is associated with increased morbidity and mortality in diabetic patients following coronary artery bypass grafting. Tight glycemic control in perioperative period can reduce these events. The goal of this study was to determine whether combination of continuous infusion and subcutaneous glargine as a basal insulin could improve glycemic control. MATERIAL AND METHODS: Diabetic patients who were candidate for CABG were randomized to receive continuous insulin infusion with or without subcutaneous Glargine insulin for at least ۷۲ hours which started ۲۴ hours before surgery and continued for ۴۸ hours after surgery. RESULTS: A total ۸۴ subjects were required. In group A (n = ۴۵) continuous insulin infusion was used for glycemic control and in group B (n = ۳۹) we used continuous insulin infusion with sub cutaneous glargine insulin. Blood glucose level was significantly better in desirable range in group B in comparison to group A. Total mean blood glucose level in group A was ۱۸۶.۱ mg/dl and in group B was ۱۷۴.۳ mg/dl (P = ۰.۰۰۸). Frequency of hypoglycemia (blood glucose <۷۰ mg/dl) was ۰.۶۶% in group A and ۰.۵% in group B that was similar (P = ۰.۵۳۰). The mean length of stay in the hospital was not different between two groups (P = ۰.۲۸۸). CONCLUSION: We found out that a combination of continuous insulin infusion and glargine insulin as main basal insulin can improve glycemic control in diabetic patients undergoing coronary artery bypass grafting.

کلیدواژه ها:

CABG ، Continuous insulin infusion ، Glargin insulin ، Diabetes.