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Metformin as an adjunct to insulin for glycemic control in patients with type 2 diabetes after CABG surgery: A randomized double blind clinical trial

Baradari, A.G. and Zeydi, A.E. and Aarabi, M. and Ghafari, R. (2011) Metformin as an adjunct to insulin for glycemic control in patients with type 2 diabetes after CABG surgery: A randomized double blind clinical trial. Pakistan Journal of Biological Sciences, 14 (23). pp. 1047-1054. ISSN 10288880 (ISSN)

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Abstract

Perioperative hyperglycemia is common in patients with type 2 diabetes undergoing Coronaiy Arteiy Bypass Graft (CABG) surgery and there is a direct relation between postoperative hyperglycemia and mortality rate in these patients. The aim of the present study is to determine the efficacy of metformin on glycemic control in diabetic patients after CABG surgery. In a randomized double blind clinical trial, 100 patients with type 2 diabetes admitted in open heart ICU after CABG surgeiy in Mazandaran Heart Center were enrolled. They were randomly assigned to two intervention and control groups. Three hours after extubation, therapeutic antiglycemic regimens were applied in these two groups and continued for three days. Intervention group received regular insulin infusion along with two metformin 500 mg tablets per twelve hours while control group received regular insulin infusion with two placebo tablets per twelve hours. Blood glucose level and other parameters were measured andrecorded in determined intervals. To analyze the data, independent T-test, paired T-test, Mann-Whitney and repeated measure ANOVA tests were employed. Mean blood glucose level was not significantly different in the two groups at the beginning of the ICU admission; however, mean glucose level in insulin-metformin group, twelve hours after the initiation of the study, was significantly lower than insulin group (p<0.05). In addition, mean doses of potassium and insulin demand as well as mean number of episodes of hyperglycemia, hypoglycemia and glucose levels out of the accepted range were significantly lower in insulin-metformin group (p<0.05). Alterations in mean levels of lactate, BE, pH and creatinine were not statistically significant in these two groups. It seems that adding metformin to insulin leads to a better glycemic control in type two diabetic patients undergoing CABG surgeiy without causing metabolic acidosis. Therefore, it might be a potential option in blood glucose control protocol in this group of patients. © 2011 asian network for scientific information.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Pak. J. Biol. Sci. [Field not mapped to EPrints] C2 - 22590838 [Field not mapped to EPrints] AD - Department of Critical Care Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] AD - Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] AD - Department of Epidemiology, Cardiovascular Research Center, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Department of Cardiac Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Cabg, Diabetes, Glycemic control, Insulin, Metformin, antidiabetic agent, insulin, metformin, placebo, article, clinical trial, controlled clinical trial, controlled study, coronary artery bypass graft, double blind procedure, drug effect, glucose blood level, hyperglycemia, non insulin dependent diabetes mellitus, pathophysiology, postoperative complication, randomized controlled trial, treatment outcome, Blood Glucose, Coronary Artery Bypass, Diabetes Mellitus, Type 2, Double-Blind Method, Hyperglycemia, Hypoglycemic Agents, Insulin, Metformin, Placebos, Postoperative Complications, Treatment Outcome
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 20 Apr 2015 08:07
Last Modified: 19 May 2015 04:33
URI: http://eprints.goums.ac.ir/id/eprint/2065

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