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Hyperglycemia is common during cardiac surgery, and strict postoperative glycemic control can decrease morbidity and mortality, but the risks and benefits of strict intraoperative glycemic control are not known. In a randomized trial, investigators compared intensive intraoperative glycemic control (insulin infusion to maintain serum glucose between 80 and 100 mg/dL) with conventional care (infusion only when serum glucose exceeded 200 mg/dL) in 371 adults undergoing on-pump cardiac surgery whose serum glucose was 100 mg/dL or higher at least once; 20% of subjects had diabetes.
After cardiopulmonary bypass, glucose concentrations were significantly lower in the intensive-treatment group (123 vs. 148 mg/dL). All subjects received intensive co…