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Continuous insulin monitoring does not raise hospital costs

HERSHEY, PA--Patients with diabetes whose glucose is continually monitored after coronary bypass artery graft surgery do not incur higher medical costs despite the additional testing, Penn State Diabetes Center researchers report.

"Increasing evidence suggests that sickness and death can be reduced among surgical patients with diabetes if we provide tighter control of blood glucose just before, during and after surgery," said Robert A. Gabbay, M.D., Ph.D., associate professor of medicine, Penn State College of Medicine, co-director, Penn State Diabetes Center. "Our study shows that continuous insulin monitoring and involvement of an endocrinologist in the patients' care do not increase the cost of treating a patient with diabetes undergoing coronary artery bypass graft surgery."

The study, titled "Improved perioperative glycemic control by continuous insulin infusion under supervision of an endocrinologist does not increase costs in patients with diabetes," was published in the April issue of the journal Endocrine Practice.

Coronary artery bypass graft (CABG) surgery is a standard treatment for advanced coronary disease in people with diabetes. In the procedure, veins are removed from the legs or arms and used to create a bypass around a blocked area in a coronary artery. As many as 25 percent of adult CABG procedures in the U.S. are performed on patients with diabetes. Morbidity, death and risk of deep sternal would infections are higher in patients with diabetes who undergo CABG surgery than in those without diabetes. Evidence suggests that those poor outcomes are due in part to hyperglycemia, or too much glucose in the blood, before, during and after surgery.

For the study, Gabbay and his team developed an Insulin infusion Glycemic Control Protocol (IGCP). The protocol established a set of steps that medical staff followed when treating the 107 patients with diabetes who underwent CABG surgery at Penn State Hershey Medical Center i
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