Effects of moderate glycemic control in type ii diabetes with insulin on arterial blood gas parameters following coronary artery bypass graft surgery

Abstract

Background:Coronary artery bypass grafting (CABG) is one of the common surgeries in patients with coronary artery disease (CAD). It is more probable for patients with diabetes to undergo surgeries due to CAD and they have a higher mortality rate compared to the othersObjectives:The aim of the present study was to assess the effects of insulin infusion therapy on blood gas parameters in two groups of patients, eligible for CABG, defined as A: well controlled diabetes (HbA1C < 7%) and B: non-diabetic patients.Patients and Methods:We followed two groups of patients, defined as patients with and without diabetes who were candidates for CABG, between March 2010 and March 2012. Patients with diabetes underwent moderate or semi-tight glycemic control, using continuous intravenous insulin infusion.Results:There were 13 male and 18 female subjects in the on-diabetic group and 11 male and 7 female patients in the controlled diabetic group. There was no significant difference between the studied participants regarding age, cardiac ejection fraction, blood pH and PO2 and PCO2 levels.Conclusions:CABG surgery adversely affects arterial blood gas (ABG) determinations. On the other hand, findings showed there is no significant difference in the ABG parameters between patients with well controlled diabetes and the ones without.

Changes in blood glucose level during and after light sedations using propofol-fentanyl and midazolam-fentanyl in diabetic patients who underwent cataract surgery

“…In the event of a rise in blood glucose level, 10 units of regular insulin was injected subcutaneously for each 100 mg/dl rise in blood glucose level higher than 150 mg/dl, in order to achieve a moderate glycemic control (90–150 mg/dl). [ 10 ] Furthermore, two vials of 50% hypertonic glucose were administrated for patients whose blood glucose level dropped below 70 mg/dl.…”

Effect of sleeve gastrectomy, Roux-en-Y gastric bypass, and ileal transposition on myocardial ischaemia–reperfusion injury in non-obese non-diabetic rats

“…Several recent clinical and experimental studies have demonstrated the important role of insulin in maintaining myocardial resistance to ischaemia–reperfusion, especially in the presence of diabetes mellitus or insulin resistance 64 . Improvement of coronary perfusion, which protects cardiomyocytes from damage, has been reported as a potential cardioprotective mechanism of insulin through vasodilation and antiplatelet effects 65 . The anti-inflammatory effect is realized by suppressing tumour necrosis factor-α (TNF-α) production 66 and is mediated through the activation of AKT protein kinase, which leads to a reduction in the size of the infarction and a decrease in myocardial contractile dysfunction.…”

Effects of glucagon-like peptide 1 analogs in combination with insulin on myocardial infarct size in rats with type 2 diabetes mellitus

“…Additionally, insulin can suppress inflammation and enhance fibrinolysis (by decreasing the activity of antifibrinolytic factors) in patients with acute MI with ST segment elevation, receiving low-dose insulin infusion and fibrinolytic therapy. These effects of insulin, along with its vasodilator and antiplatelet actions, promote reperfusion at the level of the epicardium and microcirculatory bed, and thus protect the myocardium[ 28 ].…”