INS and Hypothermia: Hypothermia and nonpulsatile flow during CPB may impair insulin production; however, studies showed that C-Peptide levels as a measurement of endogenous insulin production were not markedly diminished in patients on CPB.7–10 Heparin and the repetitive administration of glucose with the cardioplegic solution, which is used to stop the heart, are further increasing glucose levels.9,11