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Burned Adults Develop Profound Glucose Intolerance.

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Adult burn survivors exhibit significant insulin resistance and impaired glucose metabolism at discharge, with two-thirds developing prediabetes or diabetes. Early glucose intolerance screening post-burn is crucial for identifying at-risk patients.

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Area of Science:

  • Metabolic Medicine
  • Burn Injury Research
  • Endocrinology

Background:

  • Metabolic changes post-burn are established in children but poorly understood in adults.
  • Insulin sensitivity and glucose metabolism in adult burn patients remain largely uncharacterized.

Purpose of the Study:

  • To characterize metabolic alterations and insulin resistance in adult burn patients.
  • To determine the magnitude and persistence of these metabolic changes at hospital discharge.

Main Methods:

  • Prospective cohort study in a tertiary burn center.
  • Oral glucose tolerance test (OGTT) administered at discharge to non-diabetic adults with burns ≥20% total body surface area (TBSA).
  • Measured glucose, insulin, and C-peptide to calculate indices of insulin resistance and beta-cell function (e.g., HOMA-IR, QUICKI).

Main Results:

  • Forty-five adult patients (mean age 44 years, 38% TBSA burned) showed abnormal insulin sensitivity and impaired insulin production at discharge.
  • Two-thirds of patients (n=28) met criteria for impaired fasting glucose/impaired glucose tolerance or diabetes.
  • Metabolic derangements were observed irrespective of burn severity (20-30% vs. ≥30% TBSA).

Conclusions:

  • Burn-injured adults exhibit persistent hyperglycemia, insulin resistance, and defective insulin secretion at discharge.
  • OGTT at discharge identifies a high risk for prediabetes and diabetes in burn survivors.
  • Routine glucose intolerance surveillance post-discharge is recommended due to the high prevalence and association with poor outcomes.