Patients who were randomized to intensive glucose control after 9 years of follow-up had a 57% reduction in the risk of nonfatal MI, stroke, or cardiovascular death compared with patients in the standard arm.284 For patients with type 2 diabetes mellitus, evidence also exists that a more intensive control of plasma glucose may reduce macrovascular cardio- vascular disease. In the UK Prospective Diabetes Study, a 16% reduction in fatal and nonfatal MI and sudden death was noted with intensive glucose control (target fasting plasma glucose <6 mmol/L), although this failed to reach statistical signifi- Nevertheless, consistent benefits have not always been observed for patients with type 2 diabetes mellitus, with several other trials finding no added benefit of intensive glucose control over standard control on the risk of adverse cardiovascular events, even among patients with base- line cardiovascular disease at the time of trial recruitment.287 It must be recognized that none of the aforementioned stud- ies specifically enrolled diabetic patients who had undergone CABG. Regardless, although these study findings are extrap- olated from non-CABG patients to the CABG population, a moderate control of plasma glucose with a goal HbA1c of 7% would seem appropriate for most diabetic patients after CABG. In addition to optimal plasma glucose management, it cannot be overstated that all patients recovering from CABG, and especially those with diabetes mellitus, should be coun- seled to optimize their weight and diet, to quit smoking, and to institute behaviors associated with improved cardiovascular health. Diabetes Mellitus Recommendations 1. Striving to achieve an HbA1c of 7% is a reasonable goal for most patients after CABG to reduce microvascular diabetic complications and macrovascular cardiovas- cular disease (Class IIa; Level of Evidence B). 