Diabetes and impaired glucose tolerance are largely under-diagnosed in patients with acute atherosclerotic events. This glucose-unawareness is an obstacle for aggressive treatment in these patients. It is suggested to check fasting glucose levels in patients scheduled for cardiovascular surgery and to give intensive insulin therapy perioperatively if fasting glucose levels are greater than 7.0 mmol/L (126 mg/dL). If fasting glucose levels are not elevated an oral glucose tolerance test should be considered so that unknown diabetes can be detected and treated.
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