GLP 1 for Intraoperative Glycemic Control

Inclusion criteria

• male or female age (18-80 years),
• ability to provide informed consent,
• elective CABG with or without single or multivalve repair or replacement, and/ or
• single or multivalve repair or replacement requiring CPB and sternotomy (to include subjects who are undergoing first time or redo cardiac surgery).

Exclusion criteria

• concomitant surgery (e.g. carotid endarterectomy),
• emergent surgery,
• current steroid use,
• insulin dependent diabetes mellitus (IDDM),
• cardiac surgery without the use of cardiopulmonary bypass (e.g. off-pump CABG),
• current use of positive intravenous inotropic agents,
• serious intercurrent illness (endocarditis, sepsis, active malignancy requiring treatment) or active infection,
• known substance abuse,
• receipt of an investigational drug or device within 30 days prior to surgery,
• known allergy to any of the following: GLP-1, fentanyl, midazolam, isoflurane, propofol, morphine, heparin or protamine,
• Sulfonylurea medication administration on morning of surgery (such as, tolbutamide, tolazamide (Tolinase), chlorpropamide (Diabinese). glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, Glynase PresTabs, and DiaBeta), glimepiride (Amaryl),
• Major end organ dysfunction defined as:

• Cardiac: Left ventricular ejection fraction (LVEF) < 30% by left ventriculography or echocardiogram (within 90 days prior to randomization), current use of positive intravenous inotropic agents, preoperative use of intra-aortic balloon pump (IABP), left ventricular assist device (LVAD), or extracorporeal membrane oxygenation (ECMO);
• Renal: preoperative serum Creatinine > 2.0 mg/dL;
• Hepatic: aspartate aminotransferase (AST) or alanine transferase (ALT) > 2.5 x upper limit normal;
• Hematologic: preoperative hematocrit (HCT) < 30%, platelet count < 100,000/mm3, history of (or family history of) bleeding or clotting disorder;
• Patients with a history of or risk factors for acute pancreatitis (i.e. ethanol abuse, gall stones) will be excluded from this study,
• Pregnant or breastfeeding females, or
• any other condition that, in the opinion of the investigator, may compromise the safety of the subject or would preclude the subject from successful completion of the study.