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Related Experiment Videos

Insulin revisited.

Amparo E Martinez-Riquelme1, Simon P Allison

  • 1Clinical Nutrition Unit, Queen's Medical Centre, University Hospital, C Floor South Block, NG7 2UH Nottingham, UK.

Clinical Nutrition (Edinburgh, Scotland)
|January 30, 2003
PubMed
Summary
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Critical illness and injury cause metabolic changes like hyperglycemia. Insulin therapy shows promise in managing these conditions, potentially improving outcomes by controlling blood sugar and reducing catabolism.

Area of Science:

  • Metabolic response to critical illness and injury
  • Endocrinology
  • Critical care medicine

Background:

  • Injury and critical illness induce hyperglycemia, high free fatty acids, and protein catabolism.
  • This metabolic state is driven by suppressed insulin secretion and insulin resistance, exacerbated by cytokines and catabolic hormones.
  • Pre-operative carbohydrate loading can mitigate post-operative insulin resistance.

Purpose of the Study:

  • To review the role of insulin in managing metabolic disturbances during critical illness and injury.
  • To explore the potential benefits of insulin therapy beyond glycemic control in catabolic states.
  • To examine the impact of insulin-glucose-potassium therapy on sodium balance and hemodynamics in specific patient populations.

Main Methods:

Related Experiment Videos

  • Review of existing literature on insulin therapy in critical illness, injury, and related conditions.
  • Analysis of studies investigating the effects of insulin on metabolic parameters, insulin resistance, and catabolism.
  • Examination of clinical outcomes associated with insulin treatment in diabetic patients with myocardial infarction and cardiac surgery.

    • Main Results:

    • Insulin therapy effectively controls hyperglycemia and reduces the catabolic response in injured and critically ill patients.
    • Insulin-glucose-potassium therapy may promote sodium diuresis in catabolic patients with fluid overload and improve hemodynamics in heart failure.
    • Diabetic patients undergoing cardiac procedures show benefits from insulin treatment.

    Conclusions:

    • Insulin therapy offers multifaceted benefits in critical illness and injury, extending beyond glycemic control.
    • Further research is needed to elucidate whether observed clinical outcome improvements are solely due to euglycemia or other insulin effects.
    • Insulin's potential role in improving clinical outcomes in critical illness warrants continued investigation.