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Burn Causes Prolonged Insulin Resistance and Hyperglycemia

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Intensive Care Medicine

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Abstract

More than 500,000 burn injuries occur annually in the United States [1]. Although most of these burn injuries are minor, approximately 40,000 to 60,000 burn patients require admission to a hospital or major burn center for appropriate treatment [2]. Advances in therapeutic strategies, based on improved understanding of resuscitation, enhanced wound coverage, improved treatment of inhalation injury, more appropriate infection control, and better support of the hypermetabolic response to injury, have significantly improved the clinical outcome of this unique patient population over the past years [3]. However, severe burns remain a devastating injury affecting nearly every organ system and leading to significant morbidity and mortality [4]. One of the main contributors to adverse outcome of this patient population is the profound metabolic changes associated with insulin resistance and hyperglycemia [4].

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References

  1. American Burn Association (2007) Guidelines for the operation of burn centers. J Burn Care Res 28: 134–141

    Google Scholar 

  2. Nguyen TT, Gilpin DA, Meyer NA, Herndon DN (1996) Current treatment of severely burned patients. Ann Surg 223: 14–25

    Article  CAS  PubMed  Google Scholar 

  3. Herndon DN (2007) Total Burn Care. Saunders Elsevier, New York

    Google Scholar 

  4. Herndon DN, Tompkins RG (2004) Support of the metabolic response to burn injury. Lancet 363: 1895–1902

    Article  CAS  PubMed  Google Scholar 

  5. Gauglitz GG, Herndon DN, Jeschke MG (2008) Insulin resistance postburn: Underlying mechanisms and current therapeutic strategies. J Burn Care Res 29: 683–694

    Article  PubMed  Google Scholar 

  6. Gore DC, Chinkes D, Heggers J, Herndon DN, Wolf SE, Desai M (2001) Association of hyperglycemia with increased mortality after severe burn injury. J Trauma 51: 540–544

    Article  CAS  PubMed  Google Scholar 

  7. Sheridan RL, (2001) A great constitutional disturbance. N Engl J Med 345: 1271–1272

    Article  CAS  PubMed  Google Scholar 

  8. Wolfe RR (1981) Review: acute versus chronic response to burn injury. Circ Shock 8: 105–115

    CAS  PubMed  Google Scholar 

  9. Cuthbertson DP, Angeles Valero Zanuy MA, Leon Sanz ML (2001) Post-shock metabolic response. Nutr Hosp 16: 175–182

    Google Scholar 

  10. Galster AD, Bier DM, Cryer PE, Monafo WW, (1984) Plasma palmitate turnover in subjects with thermal injury. J Trauma 24: 938–945

    Article  CAS  PubMed  Google Scholar 

  11. Cree MG, Aarsland A, Herndon DN, Wolfe RR (2007) Role of fat metabolism in burn traumainduced skeletal muscle insulin resistance. Crit Care Med 35: 476–483

    Article  CAS  Google Scholar 

  12. Childs C, Heath DF, Little RA, Brotherston M (1990) Glucose metabolism in children during the first day after burn injury. Arch Emerg Med 7: 135–147

    CAS  PubMed  Google Scholar 

  13. Hart DW, Wolf SE, Mlcak R, et al (2000) Persistence of muscle catabolism after severe burn. Surgery 128: 312–319

    Article  CAS  PubMed  Google Scholar 

  14. Jeschke MG, Mlcak RP, Finnerty CC, et al (2007) Burn size determines the inflammatory and hypermetabolic response. Crit Care 11:90

    Article  Google Scholar 

  15. Norbury WB, Herndon DN (2007) Modulation of the hypermetabolic response after burn injury. In: Herndon DN (ed) Total Burn Care. Saunders Elsevier, New York, pp 420–433

    Chapter  Google Scholar 

  16. Khani S, Tayek JA (2001) Cortisol increases gluconeogenesis in humans: its role in the metabolic syndrome. Clin Sci (Lond) 101: 739–747

    Article  CAS  Google Scholar 

  17. Wolfe RR, Herndon DN, Jahoor F, Miyoshi H, Wolfe M (1987) Effect of severe burn injury on substrate cycling by glucose and fatty acids. N Engl J Med 317: 403–408

    CAS  PubMed  Google Scholar 

  18. Gore DC, Jahoor F, Wolfe RR, Herndon DN (1993) Acute response of human muscle protein to catabolic hormones. Ann Surg 218: 679–684

    Article  CAS  PubMed  Google Scholar 

  19. Wolfe RR, Durkot MJ, Allsop JR, Burke JF (1979) Glucose metabolism in severely burned patients. Metabolism 28: 1031–1039

    Article  CAS  PubMed  Google Scholar 

  20. Cree MG, Zwetsloot JJ, Herndon DN, et al (2007) Insulin sensitivity and mitochondrial function are improved in children with burn injury during a randomized controlled trial of fenofibrate. Ann Surg 245: 214–221

    Article  PubMed  Google Scholar 

  21. Robinson LE, van Soeren MH (2004) Insulin resistance and hyperglycemia in critical illness: role of insulin in glycemic control. AACN Clin Issues 15: 45–62

    Article  PubMed  Google Scholar 

  22. Gustavson SM, Chu CA, Nishizawa M, et al (2003) Interaction of glucagon and epinephrine in the control of hepatic glucose production in the conscious dog. Am J Physiol Endocrinol Metab 284: 695–707

    Google Scholar 

  23. Lang CH, Dobrescu C, Bagby GJ (1992) Tumor necrosis factor impairs insulin action on peripheral glucose disposal and hepatic glucose output. Endocrinology 130: 43–52

    Article  CAS  PubMed  Google Scholar 

  24. Baracos V, Rodemann HP, Dinarello CA, Goldberg AL (1983) Stimulation of muscle protein degradation and prostaglandin E2 release by leukocytic pyrogen (interleukin-1). A mechanism for the increased degradation of muscle proteins during fever. N Engl J Med 308: 553–558

    Article  CAS  PubMed  Google Scholar 

  25. Jahoor F, Desai M, Herndon DN, Wolfe RR (1988) Dynamics of the protein metabolic response to burn injury. Metabolism 37: 330–337

    Article  CAS  PubMed  Google Scholar 

  26. Hart DW, Wolf SE, Chinkes DL, et al (2000) Determinants of skeletal muscle catabolism after severe burn. Ann Surg 232: 455–465

    Article  CAS  PubMed  Google Scholar 

  27. Pidcoke HF, Wade CE, Wolf SE (2007) Insulin and the burned patient. Crit Care Med 35: 524–530

    Article  CAS  Google Scholar 

  28. Jeschke MG, Klein D, Bolder U, Einspanier R (2004) Insulin attenuates the systemic inflammatory response in endotoxemic rats. Endocrinology 145: 4084–4093

    Article  CAS  PubMed  Google Scholar 

  29. Jeschke MG, Klein D, Herndon DN (2004) Insulin treatment improves the systemic inflammatory reaction to severe trauma. Ann Surg 239: 553–560

    Article  PubMed  Google Scholar 

  30. Pham TN, Warren AJ, Phan HH, Molitor F, Greenhalgh DG, Palmieri TL (2005) Impact of tight glycemic control in severely burned children. J Trauma 59: 1148–1154

    Article  PubMed  Google Scholar 

  31. Hansen TK, Thiel S, Wouters PJ, Christiansen JS, Van den Berghe G (2003) Intensive insulin therapy exerts antiinflammatory effects in critically ill patients and counteracts the adverse effect of low mannose-binding lectin levels. J Clin Endocrinol Metab 88: 1082–1088

    Article  CAS  PubMed  Google Scholar 

  32. Van den Berghe G, Wouters P, Weekers F, et al (2001) Intensive insulin therapy in the critically ill patients. N Engl J Med 345: 1359–1367

    Article  PubMed  Google Scholar 

  33. Gore DC, Wolf SE, Herndon DN, Wolfe RR (2003) Metformin blunts stress-induced hyperglycemia after thermal injury. J Trauma 54: 555–561

    Article  CAS  PubMed  Google Scholar 

  34. Gore DC, Herndon DN, Wolfe RR (2005) Comparison of peripheral metabolic effects of insulin and metformin following severe burn injury. J Trauma 59: 316–323

    Article  CAS  PubMed  Google Scholar 

  35. White MF (1997) The insulin signalling system and the IRS proteins. Diabetologia 40 (Suppl 2): 2–17

    Article  Google Scholar 

  36. Folli F, Saad MJ, Backer JM, Kahn CR (1992) Insulin stimulation of phosphatidylinositol 3-kinase activity and association with insulin receptor substrate 1 in liver and muscle of the intact rat. J Biol Chem 267: 22171–22177

    CAS  PubMed  Google Scholar 

  37. Yu XX, Pandey SK, Booten SL, Murray SF, Monia BP, Bhanot S (2008) Reduced adiposity and improved insulin sensitivity in obese mice with antisense suppression of 4E-BP2 expression. Am J Physiol Endocrinol Metab 294: 530–539

    Article  CAS  Google Scholar 

  38. Saltiel AR, Pessin JE (2003) Insulin signaling in microdomains of the plasma membrane. Traffic 4: 711–716

    Article  CAS  PubMed  Google Scholar 

  39. Ikezu T, Okamoto T, Yonezawa K, Tompkins RG, Martyn JA (1997) Analysis of thermal injury-induced insulin resistance in rodents. Implication of postreceptor mechanisms. J Biol Chem 272: 25289–25295

    Article  CAS  PubMed  Google Scholar 

  40. Chang L, Chiang SH, Saltiel AR (2004) Insulin signaling and the regulation of glucose transport. Mol Med 10: 65–71

    CAS  PubMed  Google Scholar 

  41. Thurmond DC, Pessin JE (2001) Molecular machinery involved in the insulin-regulated fusion of GLUT4-containing vesicles with the plasma membrane. Mol Membr Biol 18: 237–245

    CAS  PubMed  Google Scholar 

  42. Le Roith D, Zick Y (2001) Recent advances in our understanding of insulin action and insulin resistance. Diabetes Care 24: 588–597

    Article  PubMed  Google Scholar 

  43. Hunt DG, Ivy JL (2002) Epinephrine inhibits insulin-stimulated muscle glucose transport. J Appl Physiol 93: 1638–1643

    CAS  PubMed  Google Scholar 

  44. Hotamisligil GS, Budavari A, Murray D, Spiegelman BM (1994) Reduced tyrosine kinase activity of the insulin receptor in obesity-diabetes. Central role of tumor necrosis factoralpha. J Clin Invest 94: 1543–1549

    Article  CAS  PubMed  Google Scholar 

  45. Ozcan U, Cao Q, Yilmaz E, et al (2004) Endoplasmic reticulum stress links obesity, insulin action, and type 2 diabetes. Science 306: 457–461

    Article  PubMed  CAS  Google Scholar 

  46. Ron D, Walter P (2007) Signal integration in the endoplasmic reticulum unfolded protein response. Nat Rev Mol Cell Biol 8: 519–529

    Article  CAS  PubMed  Google Scholar 

  47. Ozcan U, Yilmaz E, Ozcan L, et al (2006) Chemical chaperones reduce ER stress and restore glucose homeostasis in a mouse model of type 2 diabetes. Science 313: 1137–1140

    Article  PubMed  CAS  Google Scholar 

  48. Wellen KE, Hotamisligil GS (2005) Inflammation, stress, and diabetes. J Clin Invest 115: 1111–1119

    CAS  PubMed  Google Scholar 

  49. Shoelson SE, Lee J, Goldfine AB (2006) Inflammation and insulin resistance. J Clin Invest 116: 1793–1801

    Article  CAS  PubMed  Google Scholar 

  50. Pilon G, Dallaire P, Marette A (2004) Inhibition of inducible nitric-oxide synthase by activators of AMP-activated protein kinase: a new mechanism of action of insulin-sensitizing drugs. J Biol Chem 279: 20767–20774

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Dermatology and Allergology, Ludwig Maximilians University, Frauenlobstrasse 9-11, 80337, Munich, Germany

    G. G. Gauglitz

  2. Galveston Burns Unit, Shriners Hospitals for Children, 815 Market Street, Galveston, TX, 77550, USA

    M. G. Jeschke

Authors
  1. G. G. Gauglitz
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  2. M. G. Jeschke
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Editor information

Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Universitée libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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Gauglitz, G.G., Jeschke, M.G. (2009). Burn Causes Prolonged Insulin Resistance and Hyperglycemia. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92278-2_66

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  • DOI: https://doi.org/10.1007/978-0-387-92278-2_66

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-92277-5

  • Online ISBN: 978-0-387-92278-2

  • eBook Packages: MedicineMedicine (R0)

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