Post-traumatic insulin resistance in uninjured forearm tissue

Area of Science:

• Metabolic studies
• Trauma research
• Endocrinology

Background:

• Insulin resistance is a key feature of post-traumatic metabolism.
• The specific location and mechanisms of this insulin resistance remain unclear.

Purpose of the Study:

• To identify the site of insulin resistance following trauma.
• To investigate glucose uptake in uninjured tissues after multiple trauma.

Main Methods:

• Hyperinsulinemic glucose clamp studies were performed.
• Glucose uptake was measured in the uninjured forearm of trauma patients and healthy controls.
• Forearm glucose flux was calculated using blood flow and arterial-deep venous glucose difference.

Main Results:

• Basal forearm glucose uptake was significantly lower in trauma patients compared to controls.
• Forearm glucose uptake in trauma patients did not increase during hyperinsulinemia.
• Insulin resistance in uninjured forearm tissue was confirmed in vivo.

Conclusions:

• Post-traumatic insulin resistance is located in uninjured forearm tissue, predominantly skeletal muscle.
• Reduced glucose uptake is evident in the basal state and persists despite elevated insulin levels.
• This study provides the first in vivo evidence for peripheral insulin resistance after trauma.