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Abnormal insulin sensitivity persists up to three years in pediatric patients post-burn

Gerd G Gauglitz1, David N Herndon, Gabriela A Kulp

  • 1Shriners Hospitals for Children, Galveston, Texas 77550, USA.

The Journal of Clinical Endocrinology and Metabolism
|February 26, 2009
PubMed

Insights

Severe burns cause long-lasting insulin resistance in children, persisting for up to three years post-injury. This study tracked metabolic changes and insulin sensitivity in pediatric burn survivors.

Area of Science:

  • Pediatric endocrinology
  • Metabolic disorders
  • Burn injury research

Background:

  • The acute hypermetabolic response following severe burns leads to insulin resistance and hyperglycemia, negatively impacting patient outcomes.
  • Understanding the long-term metabolic sequelae is crucial for managing pediatric burn survivors.

Purpose of the Study:

  • To investigate the persistence of insulin resistance and related metabolic abnormalities in severely burned children for up to three years post-burn.
  • To assess changes in clinical parameters used to evaluate insulin sensitivity over time.

Main Methods:

  • A prospective study involving 194 severely burned children compared to 95 non-burned controls.
  • Measurements included urinary cortisol, catecholamines, serum cytokines, resting energy expenditure, and oral glucose tolerance tests with insulin sensitivity index calculations at multiple time points up to 36 months post-burn.

Main Results:

  • Elevated urinary cortisol, catecholamines, specific cytokines, and resting energy requirements persisted for up to 36 months.
  • Hyperglycemia was noted for 6 months, with elevated serum C-peptide and insulin persisting for 36 months.
  • Insulin sensitivity indices (ISI Matsuda, HOMA, QISSI) remained abnormal throughout the 3-year study period, confirming persistent insulin resistance.

Conclusions:

  • Severe burn injury induces stress-related insulin resistance in children.
  • This insulin resistance is not confined to the acute phase but persists for as long as three years post-burn, highlighting the need for long-term metabolic monitoring.
Abstract

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