Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery?
Hyperglycemia is associated with adverse outcomes after coronary artery bypass grafting (CABG). While there is a consensus that blood glucose control may benefit patients undergoing CABG, the role of biomarkers, optimal method, and duration of such monitoring are still unclear. The aim of this study...
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| Format: | Article |
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MDPI AG
2021-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/15/3399 |
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| author | Elena Z. Golukhova Ljubov S. Lifanova Yaroslava V. Pugovkina Marina V. Grigoryan Naida I. Bulaeva |
| author_facet | Elena Z. Golukhova Ljubov S. Lifanova Yaroslava V. Pugovkina Marina V. Grigoryan Naida I. Bulaeva |
| author_sort | Elena Z. Golukhova |
| collection | DOAJ |
| description | Hyperglycemia is associated with adverse outcomes after coronary artery bypass grafting (CABG). While there is a consensus that blood glucose control may benefit patients undergoing CABG, the role of biomarkers, optimal method, and duration of such monitoring are still unclear. The aim of this study is to define the efficacy of a continuous glucose monitoring system (CGMS) and link it to pro-inflammatory biomarkers while on insulin pump therapy in diabetic patients undergoing CABG. We prospectively assessed CGMS for 72 h in 105 patients including 52 diabetics undergoing isolated CABG. In diabetics, CGMS was connected to an insulin pump for precise glucose control. On top of conventional biomarkers (HbA1C, lipid profile), high sensitive C-reactive protein (hs-CRP), Regulated upon Activation Normal T cell Expressed and presumably Secreted (RANTES), and leptin levels were collected before surgery, 1 h, 12 h, 7 days, and at 1 year after CABG. Overall, CGMS revealed high glucose independently from underlying diabetes during first 48 h following CABG but was higher (<i>p</i> < 0.05) in diabetics. The insulin pump improved glycemic control over early follow-up (72 h) post-CABG. There were no hypoglycemic episodes in patients on insulin pump therapy and those receiving bolus insulin therapy. We revealed a lower rate of postpericardiotomy syndrome (PCTS) in patients on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (<i>p</i> = 0.03). Hs-CRP and RANTES levels were lower in patients with T2DM on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (<i>p</i> < 0.05). It is most likely due to the fact that insulin pump therapy decreases systemic inflammatory response. Further controlled trials should assess whether CGMS improves outcomes after cardiac surgery. |
| first_indexed | 2024-03-10T09:12:53Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T09:12:53Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4e3b9cf49ae44128a805c4f4a6151e0b2023-11-22T05:50:08ZengMDPI AGJournal of Clinical Medicine2077-03832021-07-011015339910.3390/jcm10153399Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery?Elena Z. Golukhova0Ljubov S. Lifanova1Yaroslava V. Pugovkina2Marina V. Grigoryan3Naida I. Bulaeva4Bakulev National Medical Research Center of Cardiovascular Surgery, Cardiology Department, Roublyevskoe Shosse 135, 121552 Moscow, RussiaBakulev National Medical Research Center of Cardiovascular Surgery, Cardiology Department, Roublyevskoe Shosse 135, 121552 Moscow, RussiaBakulev National Medical Research Center of Cardiovascular Surgery, Cardiology Department, Roublyevskoe Shosse 135, 121552 Moscow, RussiaBakulev National Medical Research Center of Cardiovascular Surgery, Cardiology Department, Roublyevskoe Shosse 135, 121552 Moscow, RussiaBakulev National Medical Research Center of Cardiovascular Surgery, Cardiology Department, Roublyevskoe Shosse 135, 121552 Moscow, RussiaHyperglycemia is associated with adverse outcomes after coronary artery bypass grafting (CABG). While there is a consensus that blood glucose control may benefit patients undergoing CABG, the role of biomarkers, optimal method, and duration of such monitoring are still unclear. The aim of this study is to define the efficacy of a continuous glucose monitoring system (CGMS) and link it to pro-inflammatory biomarkers while on insulin pump therapy in diabetic patients undergoing CABG. We prospectively assessed CGMS for 72 h in 105 patients including 52 diabetics undergoing isolated CABG. In diabetics, CGMS was connected to an insulin pump for precise glucose control. On top of conventional biomarkers (HbA1C, lipid profile), high sensitive C-reactive protein (hs-CRP), Regulated upon Activation Normal T cell Expressed and presumably Secreted (RANTES), and leptin levels were collected before surgery, 1 h, 12 h, 7 days, and at 1 year after CABG. Overall, CGMS revealed high glucose independently from underlying diabetes during first 48 h following CABG but was higher (<i>p</i> < 0.05) in diabetics. The insulin pump improved glycemic control over early follow-up (72 h) post-CABG. There were no hypoglycemic episodes in patients on insulin pump therapy and those receiving bolus insulin therapy. We revealed a lower rate of postpericardiotomy syndrome (PCTS) in patients on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (<i>p</i> = 0.03). Hs-CRP and RANTES levels were lower in patients with T2DM on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (<i>p</i> < 0.05). It is most likely due to the fact that insulin pump therapy decreases systemic inflammatory response. Further controlled trials should assess whether CGMS improves outcomes after cardiac surgery.https://www.mdpi.com/2077-0383/10/15/3399diabetes mellitusinsulinglucose monitoringcoronary bypass surgeryoutcomes |
| spellingShingle | Elena Z. Golukhova Ljubov S. Lifanova Yaroslava V. Pugovkina Marina V. Grigoryan Naida I. Bulaeva Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery? Journal of Clinical Medicine diabetes mellitus insulin glucose monitoring coronary bypass surgery outcomes |
| title | Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery? |
| title_full | Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery? |
| title_fullStr | Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery? |
| title_full_unstemmed | Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery? |
| title_short | Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery? |
| title_sort | should we monitor glucose and biomarkers in diabetics over heart surgery |
| topic | diabetes mellitus insulin glucose monitoring coronary bypass surgery outcomes |
| url | https://www.mdpi.com/2077-0383/10/15/3399 |
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