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Perioperative management of patients with diabetes is challenging because of the tension between avoiding hyperglycemia (which might impart risk for certain complications) and avoiding hypoglycemia (which can cause adverse central nervous system effects). To get accurate estimates of perioperative glycemic control, researchers used continuous glucose monitoring (CGM) in 50 adults with diabetes who underwent major surgery. All participants received glucose/insulin infusions — starting just before surgery and stopped when oral intake was resumed. Insulin was adjusted according to frequent point-of-care glucose tests, with a target range of ≈125 to 200 mg/dL; treating clinicians were blinded to CGM data.
During an average of 4 days of CGM, 38% …