Surgical Infection Risk Decreased in Lower Target Glucose
Findings among patients who underwent hepato-biliary-pancreatic surgery.
For patients undergoing hepato-biliary-pancreatic surgery, having a lower blood glucose target (4.4 to 6.1 mmol/L) is associated with reduced incidence of surgical site infection (SSI), according to a study published online ahead of print in Diabetes Care.
Takehiro Okabayashi, MD, PhD, of Kochi University in Japan, and colleagues examined whether the incidence of SSI is associated with perioperative intensive insulin therapy (IT) in surgical intensive care unit (ICU) patients. Participants were randomized to intermediate IT (225 patients; target glucose range, 7.7 to 10.0 mmol/L) or intensive IT (222 patients; target blood glucose range 4.4 to 6.1 mmol/L).
During their stay in the surgical ICU, no patients in either group became hypoglycemic (less than 4.4 mmol/L). After hepato-biliary-pancreatic surgery, the rate of SSI was 6.7%. Compared with the intermediate IT group, patients in the intensive IT group had significantly fewer postoperative SSIs (4.1% vs. 9.8%), and after pancreatic resection, the intensive IT group had a significantly lower incidence of postoperative pancreatic fistula.
Patients in the intensive IT group required a significantly shorter length of hospitalization than those in the intermediate IT group.
"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 to 10.0 mmol/L," the authors wrote.