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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

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Author(s): Afshin Gholipour Baradari | Amir Emami Zeydi | Mohsen Aarabi | Rahman Ghafari

Journal: Pakistan Journal of Biological Sciences
ISSN 1028-8880

Volume: 14;
Issue: 23;
Start page: 1047;
Date: 2011;
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Keywords: diabetes | CABG | metformin | glycemic | control | insulin

ABSTRACT
Perioperative hyperglycemia is common in patients with type 2 diabetes undergoing Coronary Artery 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 surgery 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 and recorded 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
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