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1
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Intensive insulin therapy in the surgical intensive care unit
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van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the surgical intensive care unit. N Engl J Med 2001; 345:1359-1367.
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van den Berghe, G.1
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Weekers, F.3
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2
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van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med 2006; 354:449-461. The second RCT of IIT from the Leuven group in a patient population with already established complications and organ failure secondary to underlying internal medical diagnoses. While hypoglycemic episodes were more common with IIT, morbidity was reduced significantly.
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van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med 2006; 354:449-461. The second RCT of IIT from the Leuven group in a patient population with already established complications and organ failure secondary to underlying internal medical diagnoses. While hypoglycemic episodes were more common with IIT, morbidity was reduced significantly.
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3
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32044448937
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Intensive insulin in intensive care
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Malhotra A. Intensive insulin in intensive care. N Engl J Med 2006; 354:516-518.
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Malhotra, A.1
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Intensive insulin therapy in patient with severe sepsis and septic shock is associated with an increased rate of hypoglycemia: Results from a randomized multicenter study (VISEP)
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Brunkhorst FM, Kuhnt E, Engel C, et al. Intensive insulin therapy in patient with severe sepsis and septic shock is associated with an increased rate of hypoglycemia: results from a randomized multicenter study (VISEP). Infection 2005; 33 (suppl 1):19.
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Brunkhorst, F.M.1
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Engel, C.3
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6
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17444407851
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Intraoperative glucose control in diabetic and nondiabetic patients during cardiac surgery
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Smith CE, Styn NR, Kalhan S, et al. Intraoperative glucose control in diabetic and nondiabetic patients during cardiac surgery. J Cardiothorac Vasc Anesth 2005; 19:201-208.
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Smith, C.E.1
Styn, N.R.2
Kalhan, S.3
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7
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33845539898
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Intensive insulin therapy in mixed medical/surgical intensive care units: Benefit versus harm
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A pooled analysis of the two RCTs of IIT from Leuven, showing no increased short-term or long-term morbidity or mortality due to hypoglycemic episodes, despite an increased incidence in IIT
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van den Berghe G, Wilmer A, Milants I, et al. Intensive insulin therapy in mixed medical/surgical intensive care units: benefit versus harm. Diabetes 2006;55:3151-3159. A pooled analysis of the two RCTs of IIT from Leuven, showing no increased short-term or long-term morbidity or mortality due to hypoglycemic episodes, despite an increased incidence in IIT.
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van den Berghe, G.1
Wilmer, A.2
Milants, I.3
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8
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33750237099
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Evaluation of short-term consequences of hypoglycemia in an intensive care unit
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A nested case-control study of hypoglycemic episodes in an ICU setting, showing similar results to the above study
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Vriesendorp TM, DeVries JH, van Santen S, et al. Evaluation of short-term consequences of hypoglycemia in an intensive care unit. Crit Care Med 2006; 34:2714-2718. A nested case-control study of hypoglycemic episodes in an ICU setting, showing similar results to the above study.
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Vriesendorp, T.M.1
DeVries, J.H.2
van Santen, S.3
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9
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Predisposing factors for hypoglycemia in the intensive care unit
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Vriesendorp TM, van Santen S, DeVries JH, et al. Predisposing factors for hypoglycemia in the intensive care unit. Crit Care Med 2006; 34:96-101.
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van Santen, S.2
DeVries, J.H.3
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10
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Intensive insulin therapy in the intensive care unit: Assessment by continuous glucose monitoring
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De Block C, Manuel-Y-Keenoy B, Van Gaal L, Rogiers P. Intensive insulin therapy in the intensive care unit: assessment by continuous glucose monitoring. Diabetes Care 2006; 29:1750-1756.
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Rogiers, P.4
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11
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33646339675
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Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients
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Impressively, the model predictive control algorithm developed by this group eliminated the occurrence of hypoglycemic episodes while significantly improving glycemia, as compared with current routine IIT
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Plank J, Blaha J, Cordingley J, et al. Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients. Diabetes Care 2006; 29:271-276. Impressively, the model predictive control algorithm developed by this group eliminated the occurrence of hypoglycemic episodes while significantly improving glycemia, as compared with current routine IIT.
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Plank, J.1
Blaha, J.2
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12
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Modulation of postoperative insulin resistance by preoperative carbohydrate loading
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Ljungqvist O, Nygren J, Thorell A. Modulation of postoperative insulin resistance by preoperative carbohydrate loading. Proc Nutr Soc 2002;61:329-336.
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Thorell, A.3
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Perioperative glucose infusion and the catabolic response to surgery: The effect of epidural block
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0023898120
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Effect of epidural analgesia on postoperative insulin resistance as evaluated by insulin clamp technique
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Uchida I, Asoh T, Shirasaka C, Tsuji H. Effect of epidural analgesia on postoperative insulin resistance as evaluated by insulin clamp technique. Br J Surg 1988; 75:557-562.
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15
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The metabolic response to cholecystectomy: Insulin resistance after open compared with laparoscopic operation
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Preoperative oral carbohydrate administration reduces postoperative insulin resistance
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Nygren J, Soop M, Thorell A, et al. Preoperative oral carbohydrate administration reduces postoperative insulin resistance. Clin Nutr 1998; 17:65-71.
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Preoperative oral carbohydrate treatment attenuates immediate postoperative insulin resistance
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Soop M, Nygren J, Myrenfors P, et al. Preoperative oral carbohydrate treatment attenuates immediate postoperative insulin resistance. Am J Physiol Endocrinol Metab 2001; 280:E576-E583.
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Effects of preoperative oral carbohydrates and peptides on postoperative endocrine response, mobilization, nutrition and muscle function in abdominal surgery
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Henriksen MG, Hessov I, Dela F, et al. Effects of preoperative oral carbohydrates and peptides on postoperative endocrine response, mobilization, nutrition and muscle function in abdominal surgery. Acta Anaesthesiol Scand 2003; 47:191-199.
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Henriksen, M.G.1
Hessov, I.2
Dela, F.3
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19
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Preoperative oral carbohydrate loading in colorectal surgery: A randomized controlled trial
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Noblett SE, Watson DS, Huong H, et al. Preoperative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis 2006; 8:563-569.
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Noblett, S.E.1
Watson, D.S.2
Huong, H.3
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20
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26044469927
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Effect of 'preoperative' oral carbohydrate treatment on insulin action: A randomised cross-over unblinded study in healthy subjects
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Svanfeldt M, Thorell A, Hausel J, et al. Effect of 'preoperative' oral carbohydrate treatment on insulin action: a randomised cross-over unblinded study in healthy subjects. Clin Nutr 2005; 24:815-821.
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Melis GC, van Leeuwen PA, von Blomberg-van der Flier BM, et al. A carbohydrate-rich beverage prior to surgery prevents surgery-induced immunodepression: a randomized, controlled, clinical trial. JPEN J Parenter Enteral Nutr 2006; 30:21-26. The first trial of oral preoperative carbohydrate treatment to investigate the effects on immunocompetence, showing preserved levels of HLA-DR expression with intervention.
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Melis GC, van Leeuwen PA, von Blomberg-van der Flier BM, et al. A carbohydrate-rich beverage prior to surgery prevents surgery-induced immunodepression: a randomized, controlled, clinical trial. JPEN J Parenter Enteral Nutr 2006; 30:21-26. The first trial of oral preoperative carbohydrate treatment to investigate the effects on immunocompetence, showing preserved levels of HLA-DR expression with intervention.
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22
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33750375575
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Preoperative oral carbohydrate administration to ASA III-IV patients undergoing elective cardiac surgery
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Breuer JP, von Dossow V, von Heymann C, et al. Preoperative oral carbohydrate administration to ASA III-IV patients undergoing elective cardiac surgery. Anesth Analg 2006; 103:1099-1108.
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Breuer, J.P.1
von Dossow, V.2
von Heymann, C.3
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Carli F, Galeone M, Gzodzic B, et al. Effect of laparoscopic colon resection on postoperative glucose utilization and protein sparing: an integrated analysis of glucose and protein metabolism during the fasted and fed states using stable isotopes. Arch Surg 2005; 140:593-597. A valuable addition to the sparse data on metabolic outcomes in laparoscopic surgery compared with open surgery. The minimally invasive approach was associated with an attenuation of traditional responses to major surgery, such as accelerated endogenous glucose release and impaired glucose oxidation in favor of lipid oxidation.
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Carli F, Galeone M, Gzodzic B, et al. Effect of laparoscopic colon resection on postoperative glucose utilization and protein sparing: an integrated analysis of glucose and protein metabolism during the fasted and fed states using stable isotopes. Arch Surg 2005; 140:593-597. A valuable addition to the sparse data on metabolic outcomes in laparoscopic surgery compared with open surgery. The minimally invasive approach was associated with an attenuation of traditional responses to major surgery, such as accelerated endogenous glucose release and impaired glucose oxidation in favor of lipid oxidation.
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24
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26444603382
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Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery
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A large cohort study demonstrating that intraoperative hyperglycemia commonly occurs during surgery and poses significant risks not only in patients with diabetes, but in all patients
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Doenst T, Wijeysundera D, Karkouti K, et al. Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg 2005;130:1144. A large cohort study demonstrating that intraoperative hyperglycemia commonly occurs during surgery and poses significant risks not only in patients with diabetes, but in all patients.
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, vol.130
, pp. 1144
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Doenst, T.1
Wijeysundera, D.2
Karkouti, K.3
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25
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Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients
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Gandhi GY, Nuttall GA, Abel MD, et al. Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Proc 2005;80:862-866.
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Gandhi, G.Y.1
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Abel, M.D.3
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Short-term hyperglycemia in surgical patients and a study of related cellular mechanisms
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discussion 851-853
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Turina M, Miller FN, Tucker CF, Polk HC. Short-term hyperglycemia in surgical patients and a study of related cellular mechanisms. Ann Surg 2006;243:845-851; discussion 851-853.
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Turina, M.1
Miller, F.N.2
Tucker, C.F.3
Polk, H.C.4
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27
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0037326620
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Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycemic control
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van den Berghe G, Wouters PJ, Bouillon R, et al. Outcome benefit of intensive insulin therapy in the critically ill: insulin dose versus glycemic control. Crit Care Med 2003; 31:359-366.
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Crit Care Med
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van den Berghe, G.1
Wouters, P.J.2
Bouillon, R.3
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Ellger B, Debaveye Y, Vanhorebeek I, et al. Survival benefits of intensive insulin therapy in critical illness: impact of maintaining normoglycemia versus glycemia-independent actions of insulin. Diabetes 2006; 55:1096-1105. In this intricate animal model of prolonged and critical illness, the Leuven group clearly demonstrates that glucose control is more important than insulin administration in IIT. Avoiding hyperglycemia avoids excess mortality, endothelial and leukocyte dysfunction and liver and kidney injury. Insulin had marginal positive effects on cardiac contractility and leukocyte dysfunction.
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Ellger B, Debaveye Y, Vanhorebeek I, et al. Survival benefits of intensive insulin therapy in critical illness: impact of maintaining normoglycemia versus glycemia-independent actions of insulin. Diabetes 2006; 55:1096-1105. In this intricate animal model of prolonged and critical illness, the Leuven group clearly demonstrates that glucose control is more important than insulin administration in IIT. Avoiding hyperglycemia avoids excess mortality, endothelial and leukocyte dysfunction and liver and kidney injury. Insulin had marginal positive effects on cardiac contractility and leukocyte dysfunction.
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29
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11444259403
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Protection of hepatocyte mitochondrial ultrastructure and function by strict blood glucose control with insulin in critically ill patients
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Vanhorebeek I, De Vos R, Mesotten D, et al. Protection of hepatocyte mitochondrial ultrastructure and function by strict blood glucose control with insulin in critically ill patients. Lancet 2005; 365:53-59.
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Vanhorebeek, I.1
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Langouche L, Vanhorebeek I, Vlasselaers D, et al. Intensive insulin therapy protects the endothelium of critically ill patients. J Clin Invest 2005; 115:2277-2286. IIT reduced nitric oxide levels and adhesion molecule ICAM-1, a marker of endothelial reactivity, in long stayers in the first Leuven RCT. Furthermore, iNOS gene expression in postmortem liver and skeletal muscle was lower in IIT than conventional treatment.
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Langouche L, Vanhorebeek I, Vlasselaers D, et al. Intensive insulin therapy protects the endothelium of critically ill patients. J Clin Invest 2005; 115:2277-2286. IIT reduced nitric oxide levels and adhesion molecule ICAM-1, a marker of endothelial reactivity, in long stayers in the first Leuven RCT. Furthermore, iNOS gene expression in postmortem liver and skeletal muscle was lower in IIT than conventional treatment.
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31
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33749571345
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Cortisol response to critical illness: Effect of intensive insulin therapy
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Vanhorebeek I, Peeters RP, Vander Perre S, et al. Cortisol response to critical illness: effect of intensive insulin therapy. J Clin Endocrinol Metab 2006; 91:3803-3813.
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J Clin Endocrinol Metab
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Vanhorebeek, I.1
Peeters, R.P.2
Vander Perre, S.3
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32
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0031051886
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Glucose control lowers the risk of wound infection in diabetics after open heart operations
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Zerr KJ, Furnary AP, Grunkemeier GL, et al. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg 1997; 63:356-361.
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Zerr, K.J.1
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Schricker T, Gougeon R, Eberhart L, et al. Type 2 diabetes mellitus and the catabolic response to surgery. Anesthesiology 2005; 102:320-326. The key aspects of postoperative insulin resistance are worse in type 2 diabetes mellitus, emphasizing the importance of glucose control, particularly in this growing population.
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Schricker T, Gougeon R, Eberhart L, et al. Type 2 diabetes mellitus and the catabolic response to surgery. Anesthesiology 2005; 102:320-326. The key aspects of postoperative insulin resistance are worse in type 2 diabetes mellitus, emphasizing the importance of glucose control, particularly in this growing population.
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