Randomized Controlled Trial of Intensive Versus Conservative Glucose Control in Patients Undergoing Coronary Artery Bypass Graft Surgery: GLUCOCABG Trial.

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Presentation transcript:

Randomized Controlled Trial of Intensive Versus Conservative Glucose Control in Patients Undergoing Coronary Artery Bypass Graft Surgery: GLUCOCABG Trial Featured Article: Guillermo Umpierrez, Saumeth Cardona, Francisco Pasquel, Sol Jacobs, Limin Peng, Michael Unigwe, Christopher A. Newton, Dawn Smiley-Byrd, Priyathama Vellanki, Michael Halkos, John D. Puskas, Robert A. Guyton, and Vinod H. Thourani Diabetes Care Volume 38: September, 2015

STUDY OBJECTIVE The optimal level of glycemic control needed to improve outcomes in cardiac surgery patients remains controversial Umpierrez G. et al. Diabetes Care 2015;38:

STUDY DESIGN AND METHODS After coronary artery bypass (CABG) surgery, patients with and without diabetes with hyperglycemia were randomized to two groups: An intensive glucose target of 100–140 mg/dL A conservative target of 141–180 mg/dL After the intensive care unit (ICU), patients received a single treatment regimen in the hospital and 90 days postdischarge Primary outcome was differences in a composite of complications, including: Mortality Wound infection Pneumonia Bacteremia Respiratory failure Acute kidney injury Major cardiovascular events Umpierrez G. et al. Diabetes Care 2015;38:

RESULTS Mean glucose in the ICU was 132 ± 14 mg/dL in the intensive and 154 ± 17 mg/dL in the conservative group There were no signiﬁcant differences in the composite of complications between intensive and conservative groups No differences in complications occurred among patients with diabetes treated with intensive or conservative regimens There was a signiﬁcantly lower rate of complications in patients without diabetes treated with intensive compared with conservative treatment regimen Umpierrez G. et al. Diabetes Care 2015;38:

CONCLUSIONS Intensive insulin therapy to target glucose of 100 and 140 mg/dL in the ICU did not signiﬁcantly reduce perioperative complications compared with target glucose of 141 and 180 mg/dL after CABG surgery There was a lower number of complications in patients without diabetes, but not in patients with diabetes treated with the intensive regimen Umpierrez G. et al. Diabetes Care 2015;38: