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Although many clinicians believe that tight perioperative glycemic control might prevent postoperative complications in patients with diabetes, such an effect has not been seen consistently in clinical trials. In a meta-analysis of 20 randomized clinical trials (2670 patients with diabetes), researchers assessed the effects of intensive versus standard blood glucose control in the perioperative period. Surgical interventions included major cardiac and noncardiac surgeries; glucose control interventions and algorithms varied among studies.
Intensive glucose control and standard control yielded no difference in all-cause mortality (10% vs. 9%, with high certainty of evidence [CoE]), infectious complications (13% vs. 18%; low CoE), or hospital …