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(Circulation. 2008;118:105-106.)
© 2008 American Heart Association, Inc.

Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Inadequate Blood Glucose Control Is Associated With In-Hospital Mortality and Morbidity in Diabetic and Nondiabetic Patients Undergoing Cardiac Surgery

 
Our study demonstrates that inadequate blood glucose control (BGC) after cardiac surgery is not specific to patients with diabetes mellitus (DM). Inadequate BGC, regardless of DM status, was independently associated with in-hospital mortality and morbidity. Our findings have epidemiological, clinical, academic, and financial implications. We suggest that DM patients represent only a fraction of those suffering derangement of glucose metabolism after surgery. The projected future number of adults with DM is an underestimate of the number likely to be affected by deranged glucose metabolism and its related complications. Inadequate BGC after surgery seems to represent a separate clinical entity that is explained only partially by undiagnosed and diet-controlled diabetes. Our data suggest that strict protocols to maintain BGC should be used for all patients. However, the efficacy of these protocols and the pathophysiologic mechanisms of this condition need further research. In addition, further research and guidelines as to how best to manage these patients are needed. Currently, important clinical decisions such as choice of screening test, strategy for maintaining adequate BGC, and the ideal target level of BGC are often left to the individual clinician. This has resulted in inconsistencies in the definition of undiagnosed DM, stress hyperglycemia, and inadequate BGC; marked variation in estimates of prevalence; and significant variation in treatment, the impact of which remains uncertain. Our findings also may apply to patients admitted for major noncardiac surgery. The impact on life expectancy and on hospital resources is potentially enormous. See p 113.

	Prediction of First Events of Coronary Heart Disease and Stroke With Consideration of Adiposity

 
The key determinants of . . . [Full Text of this Article]

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