The quality of evidence is downgraded by study limitations (high loss to follow-up) and by imprecise results (wide confidence intervals).
Tight perioperative glycaemic control cannot be suggested over conventional blood glucose control.
A Cochrane review [Abstract] 1 included 12 trials with a total of 1403 patients to assess the effects of perioperative glycaemic control for diabetic patients undergoing surgery. Participants of any age, sex or ethnicity with previously diagnosed type 1 or 2 diabetes mellitus were included. The duration of the intervention ranged from just the duration of the surgical procedure up to 90 days. In most trials, patients underwent cardiovascular surgeries. The main outcomes are summarized in table 1.
| Outcome | Number of participants (studies) | Follow-up | Relative effect(95% CI) |
|---|---|---|---|
| Death from any cause | 1365 (11) | 20 to 90 days | RR 1.19 (0.89 to 1.59) |
| Infectious complications | 627 (8) | 48 h to 90 days | RR 0.46 (0.18 to 1.18) |
| Cardiovascular events | 682 (6) | 4 to 30 days | RR 1.03 (0.21 to 5.13) |
| Renal failure | 434(2) | 48 h to 90 days | RR 0.61 (0.34 to 1.08) |
| Hypoglycaemic episodes | 724 (3) | 18 h to 90 days | RR 6.92 (2.04 to 23.41) |
The total number of deaths from any cause was 83/680 (12.2%) in the intensive treatment group and 66/685 (9.6%) in the regular treatment group.
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