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Cited by 119Hyperglycemia and glycemic control in critically ill and hospitalized patientsSurgical site infection preventionEnhanced Recovery After Surgery

Intensive versus intermediate glucose control in surgical intensive care unit patients

Open access
Okabayashi, Takehiro, Shima, Yasuo, Sumiyoshi, Tatsuaki, Kozuki, Akihito, Tokumaru, Teppei, Iiyama, Tasuo, Sugimoto, Takeki, Kobayashi, Michiya +2 more·2014·Diabetes Care
DOI 10.2337/dc13-1771
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Abstract

Objective The optimal perioperative blood glucose range to improve surgical site infection (SSI) in surgical intensive care unit (ICU) patients remains unclear. We sought to determine whether the incidence of SSI is reduced by perioperative intensive insulin therapy (IT). Research design and methods Patients were randomly assigned to receive perioperative intensive IT, with a target blood glucose range of 4.4-6.1 mmol/L, or intermediate IT, with a target blood glucose range of 7.7-10.0 mmol/L in the surgical ICU. We defined the primary end point as the incidence of SSI. Results Study participants were randomly assigned to glucose control with one of two target ranges: for 225 patients in the intermediate IT group or for 222 patients in the intensive IT group, respectively. No patients in either group became hypoglycemic ( Conclusions We found that intensive IT decreased the incidence of SSI among patients who underwent hepato-biliary-pancreatic surgery: a blood glucose target of 4.4 to 6.1 mmol/L resulted in lower rate of SSI than did a target of 7.7-10.0 mmol/L.

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  • Overall evidence supports preadmission treatment of hyperglycemia in people scheduled for elective surgery as an effective means of reducing adverse outcomes.

    “Overall evidence supports preadmission treatment of hyperglycemia in people scheduled for elective surgery as an effective means of reducing adverse outcomes (139,140).”

    From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [140]

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Authors
Okabayashi, T., Shima, Y., Sumiyoshi, T., Kozuki, A., Tokumaru, T., Iiyama, T., Sugimoto, T., Kobayashi, M., Yokoyama, M., & Hanazaki, K.
Affiliations
University of Kochi (JP)
Corresponding author
Okabayashi, Takehiro
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2014-05-10
Volume
37
Issue
6
Pages
1516-1524
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc13-1771
OpenAlex
W2136437903
Cited by
119
References
4
Citations by year
2026: 8 · 2025: 4 · 2024: 10 · 2023: 9 · 2022: 9 · 2021: 8 · 2020: 13 · 2019: 7 · 2018: 20 · 2017: 7 · 2016: 12 · 2015: 8 · 2014: 4
FWCI
8.31
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Medicine › Surgery › Surgical site infection prevention
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
Keywords
intensive insulin therapy, perioperative blood glucose control, surgical site infection, hepatopancreatobiliary surgery, pancreatic fistula, length of hospital stay, hypoglycemia, surgical intensive care unit
MeSH terms
Aged, Biliary Tract Diseases, Blood Glucose, Female, Hospitalization, Humans, Hypoglycemic Agents, Insulin, Intensive Care Units, Liver Diseases, Male, Pancreatic Diseases, Postoperative Complications, Prognosis, Prospective Studies, Surgical Wound Infection

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