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Effects of insulin on glucose metabolism in sepsis


Authors: Z. Rušavý;  S. Lacigová;  Z. Jankovec;  M. Žourek;  M. Krčma
Authors place of work: Diabetologické a nutriční centrum, I. interní klinika Lékařské fakulty UK a FN, Plzeň, přednosta prof. MUDr. Karel Opatrný, jr., DrSc.
Published in the journal: Vnitř Lék 2006; 52(5): 429-432
Category: Diabetes and other subjects (infection, dermatovenerology and rheumatology) Hradec Králové 3 to 4 June 2005

Summary

The study surveys potential effects of hyperglycemia on prognosis, complications and mortality of critical patients. Normalization of glycemia seems to be an effective therapeutic approach that influences morbidity and mortality of critical patients. Although insulin therapy has many positive effects, it is rather a way how to achieve normoglycemia. Authors present their own research of the impact of plasmatic insulin levels on glucose metabolism. It seems that the ability of critical patients to utilise and store glucose is significantly decreased due to their insulin resistance. Glucose oxidation is decreased only slightly. Glucose utilisation and oxidation in sepsis can be enhanced by administration of insulin.

Key words:
sepsis – insulin clamp – indirect calorimetry – glycaemia – diabetes mellitus – insulin


Zdroje

1. Jevenandam M, Petersen SR, Shamos R. Protein and glucose fuel kinetics and hormonal changes in elderly trauma patients. Metabolism 1993; 42: 1255-1262.

2. Preiser J, Devos P, Van den Berghe G. Tight control of glycaemia in critically ill patients. Current Opinion in Clin Nutr and Metab Care 2002; 5: 533-537.

3. Weir CJ, Murray GD. Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long term follow up study. BMJ 1997; 314: 1303-1316.

4. Capes SE, Hunt D. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients. Stroke 2002; 32: 2426-2432.

5. Mullner M, Sterz F, Binder M et al. Blood glucose concentration after cardiopulmonary resuscitation influences functional neurological recovery in human cardiac arrest survivors. J Cerebr Blood Flow Metab 1997; 17: 430-436.

6. Norhammar AM, Ryden L, Malmberg K. Admission plasma glucose: independent risk factor for long-term prognosis after myocardial infarction even in nondiabetic patients. Diabetes Care 1999; 22: 1827-1837.

7. Capes SE, Hunt D, Malmberg K et al. Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 2000; 355: 773-778.

8. Latham RL, Lancaster AD, Hunt D at al. The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery. Infect. Control Hosp Epidemiol 2001; 22: 607-612.

9. Delamaire M, Maugendre D. Impaired leukocytes functions in diabetic patients. Diab Med 1996; 14: 29-34.

10. Pomposelli JJ, Baxter JK, Babineau TJ et al. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. J Parent Enteral Nutr 1998; 22: 77-81.

11. Rušavý Z, Šrámek V, Lacigová S et al. Influence of insulin on glucose metabolism and energy expenditure in septic patients. Critical Care 2004; 8: R213-R220.

12. Rušavý Z, Macdonald IA, Šrámek V et al. Glycemia influences on glucose metabolism in sepsis during hyperinsulinemic clamp. JPEN 2005; 29: 171-175.

13. Raply L, Cayeux M, Schneider P et al. Effects of lactate on glucose metabolism in healthy subjects and in severely injured hyperglycemic patients. Amer J Physiol 1995; 431(4): E630-E635.

14. Pilz G, Appel R,Gurniak T et al. APACHE II und Elebute Score-Berechnung und Sepsisbeurteilung auf der Intensivstation anhand eines BASIC Computerprogramms. Intensivmed 1992; 29: 81-89.

15. Ling PR, Bistrian BR, Mendez B et al. Effects of systemic infusions of Endotoxin, Tumor necrosis factor and Interleukin-1 on glucose metabolism in the rat: Relationship to endogenous glucose production and peripheral tissue glucose uptake. Metabolism 1994; 43: 279-284.

16. Valarini R, Sousa MF, Kalil R et al. Anabolic effects of insulin and aminoacids in promoting nitrogen accretion in postoperative patients. J Parent Enteral Nutrition 1994; 18: 214-218.

17. Pearlstone DB, Wolf RF, Berman RS et al. Effect of systemic insulin on protein kinetics in postoperative cancer patients. Ann Surg Oncology 1994; 1: 321-332.

18. Wistbacka JOM, Lepojarvi MVK, Karlqvist KEV et al. Amino acid-enriched glucose-insulin-potassium infusion improves hemodynamic function after coronary bypass surgery. A double-blind study in patients with unstable abgina and/or compromised left ventricular function. Infusionstherapie und Transfusionsmedizin 1995; 22: 82- 90.

19. Hiesmayr M, Haider WJ, Grubhofer G et al. J Cardiothoracic Vasc Anesthesia 1995; 9: 653-658.

20. Das UN. Is insulin an anti-inflammatory molecule? Nutrition 2001; 17: 409-413.

21. Gore DC, Wolf SE, Herndon DN et al. Relative influence of glucose and insulin on periferal amino acid metabolism in severely burned patients. J Parent Enteral Nutr 2002; 26: 271-277.

22. DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol 1979; 237: E214-E223.

23. Mandarino LJ, Consoli A, Jain A, et al. Differential regulation of intracelular glucose metabolism by glucose and insulin in human muscle. Amer J Physiol 1993; 265: E878-E905.

24. Rovlias A, Kotsou S. The influence of hyperglycaemia on neurological outcome in patients with severe head injury. Neurosurgery 2000; 46: 335-342.

25. Flynn MD, Boolell M, Topme JE et al. The effect of insulin infusion on capillary blood flow in the diabetic neuropatic foot. Diabetic Medicine 1992; 9: 630-634.

26. Preiser JCH, Devos P, Van den Berghe G Tight control of glycaemia in critically ill patients. Cur Op Clin Nutr Metab Care 2002; 5: 533-537.

27. Van den Berghe G, Wouters P, Weekers F et al. Intensive insulin therapy in critically ill patients. N Engl J Med 2001; 345: 1359-1367.

28. Malmberg K, Norhammar A, Wedel H et al. Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: long-term results from the DIGAMI study. Circulation 1999; 99: 2626-2632.

29. Malmberg K, Rydén L, Wedel H et al. Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortality and morbidity. Europ Heart J 2005; 26: 650-661.

Štítky
Diabetology Endocrinology Internal medicine

Článok vyšiel v časopise

Internal Medicine

Číslo 5

2006 Číslo 5
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