This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Diabetic patients who require Coronary Artery Bypass Graft (CABG) surgery have higher perioperative morbidity and mortality and decreased long-term survival. Our earlier GCRC study has shown that maintaining serum glucose of less than 200 mg/dl using a low dose glucose-insulin-potassium (GIK) solution decreased morbidity, shortened hospital length of stay and resulted in better long-term survival and a lower incidence of recurrent ischemia. In this study, we will compare clinical outcomes using three types of solutions given during CABG surgery in diabetics: (1) a low dos GIK solution; (2) an insulin drip; and (3) a high dose GIK solution.
The aim of the study will be to determine the optimal method for glycemic control and define the relationship between glycemic control, myocardial metabolism, and inflammatory and oxidative stress to determine which solution will result in the least morbidity and mortality in these diabetic CABG patients.
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