Continuous insulin infusion is associated with a reduced post-surgical length of stay, but not with the complication rate, in patients with diabetes mellitus undergoing coronary artery bypass graft.

Overview

OBJECTIVE: To establish if glucose management with continuous intravenous insulin infusion (CII) in the early post-operative period after coronary artery bypass graft (CABG) surgery is associated with complication rate and length of hospital stay (LOS) in patients with diabetes mellitus (DM). RESEARCH DESIGN AND METHODS: We reviewed the records of 587 patients with DM who underwent CABG from January 1999 until January 2008; 316 patients were placed on CII, while 271 patients were treated with subcutaneous insulin. We examined patient age, glycated hemoglobin (HgbA1c), 24- and 72-h post-operative average capillary blood glucose (CBG), length of stay (LOS), and the rate of complications. RESULTS: There was no difference in HgbA1c between the groups. Mean CBG values at both 24 h and 72 h remained the same in the CII group (167 mg/dl), while in the non-CII group they were 194 mg/dl and 189 mg/dl, respectively (p<0.001 between the groups). Post-surgical median LOS was 6 days in the CII group and 6.5 days in the non-CII group (p=0.003). Complications occurred at similar rate (in 10% and 11% of patients) in the two groups. CONCLUSIONS: CII is associated with a reduced post-surgical LOS in patients with DM who undergo CABG.