Editorial

Perioperative Glucose Control: How Tight Is Just Right for Everyone?

Authors: Ann S. Reed, MD, MS, Douglas B. Coursin, MD

Abstract

In this issue of the Southern Medical Journal, Smiley and Umpierrez1 provide a concise summary of perioperative glucose control in the diabetic patient, a topic that deserves the attention of all practitioners caring for such patients. As they describe, in-hospital hyperglycemia is an independent risk factor for adverse outcomes in patients with diagnoses such as stroke2 and acute myocardial infarction,3,4 and confers increased risk of infection5 and mortality in the intensive care unit.6–8 Unfortunately, the burden of disease is also high.9 The prevalence of diabetes mellitus in hospitalized patients is unknown but is thought to be at least 12.4 to 25%,10 and is likely higher in specific at-risk groups such as cardiac surgery patients.11 Achieving glycemic control in the diabetic patient is essential to patient outcomes and needs to become the routine standard of care.

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