OBJECTIVE

To assess an efficacy of continuous glucose monitoring system (CGMS) combined with insulin pump therapy for perioperative glycemic control after coronary artery bypass grafting (CABG).

MATERIAL AND METHODS

We used CGMS for 72 hours in 105 patients with coronary artery disease including 52 ones with diabetes mellitus type 2 (DM2). Patients with DM2 were divided into 2 subgroups: insulin pump therapy (subgroup 1) and bolus intravenous insulin according to in-hospital protocol (subgroup 2). We analyzed pro-inflammatory markers, adipokines and incidence of postoperative complications in 7 days and 1 year after CABG.

RESULTS

There were high glucose levels in patients with and without DM2 within 48 hours after CABG. Patients with DM2 had significantly higher glucose level (p<0.05). Insulin pump therapy ensured target glycemia in most cases (62.5%) while bolus intravenous insulin injection was followed by normal glucose level in 21.4% of patients (p=0.003). There were no hypoglycemic episodes. Insulin pump therapy significantly decreased highly sensitive C-reactive protein after 12 hours (p=0.0001), RANTES after 7 days (p=0.035) and incidence of postpericardiotomy syndrome (p=0.03).

CONCLUSION

CGMS combined with insulin pump therapy is safe and effective for perioperative glycemic control, as well as decrease of the incidence of postpericardiotomy syndrome.