Stress hyperglycemia is a common phenomenon in cardiac surgery that concerns diabetic and non
diabetic patients.
It has been shown that perioperative hyperglycemia is an independent risk factor of
postoperative mortality and morbidity.
The Leuven et al.'s study suggested that strict glycemic perioperative control using an
intensive insulin therapy could reduce mortality and morbidity in surgical intensive care's
patients. This study included a majority of cardiac surgery patients. Others studies have
suggested that the beneficial effect of insulin-based tight perioperative glycemic control
might be hampered by iatrogenic hypoglycemia. Moreover, insulin therapy failed to obtain
perioperative glycemic stability in most patients.
Exenatide (Byetta ®) is an incretin mimetic, characterized by an anti-hyperglycemic effect
that depends on the blood glucose level.
We hypothesize that continuous intravenous infusion of exenatide could improve perioperative
glycemic control and stability and could reduce the risk of iatrogenic hypoglycemia compared
to a conventional insulin therapy during the perioperative period of cardiac surgery.