Cardiovascular Surgery, Vol. 11, No. 3, pp. 195–200, 2003  2003 The International Society for Cardiovascular Surgery Published by Elsevier Science Ltd. All rights reserved. 0967-2109/03 $30.00 www.elsevier.com/locate/cardiosur doi:10.1016/S0967-2109(03)00019-X Multidisciplinary intervention for control of diabetes in patients undergoing coronary artery bypass graft (CABG) Ohad Cohen *,‡ , Rachel Dankner *,‡ , Angela Chetrit † , Osnat Luxenburg †,‡ , Claude Langenauer * , Amihay Shinfeld ‡,§ and Aram K. Smolinsky ‡,§ * Institute of Endocrinology, Sheba Medical Center, Tel-Hashomer, Israel, † Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel, ‡ Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel and § Chest Surgery Department, Sheba Medical Center, Tel-Hashomer, Israel In Israel, as elsewhere, diabetes mellitus is highly prevalent among patients undergoing coron- ary artery bypass graft (CABG). The bulk of evidence, derived retrospectively, suggests that poor control of diabetes predisposes to complications of CABG and increases mortality; but the findings in a number of studies fail to support that impression. Anticipating a prospective investigation designed to resolve this issue, we have carried out a preliminary study of 147 consecutive patients with diabetes who were hospitalized for elec- tive CABG during 1998. Our objective was to determine how well and how often diabetes could be controlled in accordance with selected metabolic goals in the brief interval between hospital admission and surgery and during the operation itself and in the postoperative period. The task was undertaken by a multidisciplinary team, in cooperation with the Department of Car- diac Surgery. The metabolic goals were: fasting blood glucose consistently between 65–140 mg/dl before and after surgery and 120–180 mg/dl at the time of surgery; and postprandial blood glucose consistently 180 mg/dl. These goals were achieved in 18.1% of fasting blood glucose measurements before and after surgery, 22.1% of preprandial and 14.6% of post- prandial blood glucose levels consistently 180 mg/dl. There were no clinical episodes of hypo- glycemia. Due to the low incidence of major infection related complications (deep sternal wound infec- tion in only 3 patients (2.0%)) no significant statistical conclusions on the relations between glucose control and these complications could be drawn. The means of all values of FBG and of hemoglobin A1c were significantly higher among patients with complications (n=49) than in those without (P=0.01).  2003 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved. Keywords: Diabetes, Control, CABG, Intervention, Outcome measures Introduction Diabetes Mellitus is a well-established risk factor for the development of coronary artery disease (CAD) Correspondence to: O. Cohen. Tel.: +972-3-5302374; fax: +972-3- 5302083; e-mail: ohdcohen@sheba.health.gov.il CARDIOVASCULAR SURGERY JUNE 2003 VOL 11 NO 3 195 and for the consequences of CAD, once established [1]. As a corollary to this, almost 12% of patients undergoing coronary artery bypass-grafting (CABG) in the United States have diabetes [2]. The corre- sponding figure at our hospital approaches 30% [3], as compared to a prevalence of 17% in an age-matched segment of the general population in Israel [4].