| Insulin resistance postburn: underlying mechanisms and current therapeutic strategies. | |
| | |
MedLine Citation:
|
PMID: 18695610 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The profound hypermetabolic response to burn injury is associated with insulin resistance and hyperglycemia, significantly contributing to the incidence of morbidity and mortality in this patient population. These responses are present in all trauma, surgical, or critically ill patients, but the severity, length, and magnitude is unique for burn patients. Although advances in therapeutic strategies to attenuate the postburn hypermetabolic response have significantly improved the clinical outcome of these patients during the past years, therapeutic approaches to overcome stress-induced hyperglycemia have remained challenging. Intensive insulin therapy has been shown to significantly reduce morbidity and mortality in critically ill patients. High incidence of hypoglycemic events and difficult blood glucose titrations have led to investigation of alternative strategies, including the use of metformin, a biguanide, or fenofibrate, a peroxisome proliferator-activated receptor (PPAR)-gamma agonist. Nevertheless, weaknesses and potential side affects of these drugs reinforces the need for better understanding of the molecular mechanisms underlying insulin resistance postburn that may lead to novel therapeutic strategies further improving the prognosis of these patients. This review aims to discuss the mechanisms underlying insulin resistance induced hyperglycemia postburn and outlines current therapeutic strategies that are being used to modulate hyperglycemia after thermal trauma. |
| | |
Authors:
|
Gerd G Gauglitz; David N Herndon; Marc G Jeschke |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
|
Title: Journal of burn care & research : official publication of the American Burn Association Volume: 29 ISSN: 1559-047X ISO Abbreviation: - Publication Date: 2008 Sep-Oct |
Date Detail:
|
Created Date: 2008-09-10 Completed Date: 2009-01-14 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101262774 Medline TA: J Burn Care Res Country: United States |
Other Details:
|
Languages: eng Pagination: 683-94 Citation Subset: IM |
Affiliation:
|
Shriners Burns Hospital for Children, Galveston, Texas 77550, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Antilipemic Agents
/
therapeutic use Blood Glucose / drug effects* Burns / complications*, metabolism*, physiopathology Humans Hyperglycemia / etiology*, metabolism, prevention & control Hypoglycemic Agents / therapeutic use Insulin Resistance* Metformin / therapeutic use PPAR gamma / drug effects, metabolism Procetofen / therapeutic use Risk Factors Time Factors |
| Grant Support | |
ID/Acronym/Agency:
|
P50 GM60338/GM/NIGMS NIH HHS; R01-GM56687/GM/NIGMS NIH HHS; T32 GM008256/GM/NIGMS NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Antilipemic Agents; 0/Blood Glucose; 0/Hypoglycemic Agents; 0/PPAR gamma; 49562-28-9/Procetofen; 657-24-9/Metformin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Thigh burn associated with laptop computer use.
Next Document: Adverse clinical outcomes associated with elevated blood alcohol levels at the time of burn injury.