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Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: LH holds shares in the Profil Institute for Metabolic Research, Neuss, Germany, and the Profil Institute for Clinical Research, San Diego, USA. JW is a consultant for a number of companies developing insulin pumps and infusion sets (including Roche Diagnostics). He is employed by Advanced Metabolic Care and Research, which conducts numerous studies in diabetes including insulin pumps, infusion sets, and insulins. RR has no disclosures. LH and JW are also consultants for a range http://www.selleckchem.com/products/INCB18424.html of companies that develop new diagnostic and therapeutic options for the treatment of Amiloride diabetes. Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.""Continuous insulin infusion (CII) protocols with glycemic targets 110-140 mg/dl are suggested following cardiac surgery in patients with and without diabetes provided that these targets can be achieved with low risk for moderate (MH) and severe (SH) hypoglycemia.1-4 The purpose of this investigation was to investigate differences in efficacy and safety of these targets according to diabetes status. Glycemic data were collected from 247 consecutive patients treated with 1 of 2 published CII protocols (P1 and P2) targeting blood glucose (BG) 110-140 mg/dl for ��48 hours following cardiac surgery.5 Diabetes status was defined by medical record documentation or preoperative A1c �� 6.5%.6 Protocol efficacy was measured by time to BG target; percentage of BG 70-109, 110-140, 141-180, and >180 mg/dl; and percentage of patients with BG in target after goal achieved. Glycemic variability was determined as the BG coefficient of variation (CV). Protocol safety was defined as percentage of BG 40-69 mg/dl (MH) and Vemurafenib solubility dmso with and without diabetes, no differences were observed in clinical characteristics (Table 1). Glycemic outcomes were similar for patients with and without diabetes treated with P1, but not P2, where diabetes patients were less likely to have BG within goal, with higher mean BG and more glycemic variability than P2 patients without diabetes. P2 diabetes patients were older, were more obese, required more pressors, and took longer to achieve goal than those without diabetes. When comparing P1 and P2 diabetes groups, there were no differences in the percentage of patients treated with insulin (31% vs 42%) or oral agents (39% vs 49%) prior to admission.
