The researchers explain the possible theories, including the possibility that appropriate concentration of glucose for survival under stress-related conditions may be much higher in patients with insulin treated diabetes mellitus to provide energy for wound repair and to recover from major physiological insults.
They conclude these finding suggest that “current recommendations, which use a single maximum glucose threshold for the control of stress hyperglycaemia after cardiac surgery, may not achieve the intended benefits in all patient subgroups. Such a blanket approach could instead be harmful to patients with more advanced diabetes. Given the substantial clinical benefits that may be attained, patient stratification with indicators of chronic glucose dysregulation should be investigated”.