Tight Glycemic Control in Diabetic Coronary Artery Bypass Graft Patients Improves Perioperative Outcomes and Decreases Recurrent Ischemic Events

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Abstract
Background— This study sought to determine whether tight glycemic control with a modified glucose-insulin-potassium (GIK) solution in diabetic coronary artery bypass graft (CABG) patients would improve perioperative outcomes. Methods and Results— One hundred forty-one diabetic patients undergoing CABG were prospectively randomized to tight glycemic control (serum glucose, 125 to 200 mg/dL) with GIK or standard therapy (serum glucose P P =0.0017), and a shorter postoperative length of stay (6.5±0.1 versus 9.2±0.3 days; P =0.003). GIK patients also showed a survival advantage over the initial 2 years after surgery ( P =0.04) and decreased episodes of recurrent ischemia (5% versus 19%; P =0.01) and developed fewer recurrent wound infections (1% versus 10%, P =0.03). Conclusions— Tight glycemic control with GIK in diabetic CABG patients improves perioperative outcomes, enhances survival, and decreases the incidence of ischemic events and wound complications.

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