Glucose Control Hyperglycemia often occurs during and after CABG, partic- ularly when CABG is performed on pump. Intraoperative hyperglycemia is associated with an increased morbidity rate in patients with diabetes590 and with excess mortality in patients with and without diabetes.591 Hyperglycemia during CPB is an independent risk factor for death in patients undergoing cardiac surgery. A retrospective observational study of 409 cardiac surgical patients identified intraoperative hyperglycemia as an independent risk factor for perioperative complications, including death, and calculated a 34% in- creased likelihood of postoperative complications for every 20-mg/dL increase in blood glucose concentration 100 mg/dL during surgery.592 An RCT of critically ill patients, many of whom had high-risk cardiac surgery, found reduced morbidity and mortality rates in those whose blood glucose was tightly controlled,583 and follow-up of these subjects showed that this benefit persisted for up to 4 years.582 The Portland Diabetes Project, begun in 1992, was the first large study to elucidate the detrimental effects of hyperglycemia in relation to CABG outcomes. This prospective observational study described the evolution in management of cardiac surgical patients with diabetes mellitus from a strategy of intermittent subcutaneous injections of insulin to one of continuous intrave- nous insulin infusion with decreasing target glucose concentra- tions. 