Differentiation between septic and postburn insulin resistance

Robert E. Shangraw, Farook Jahoor, Hiroshi Miyoshi, William A. Neff, Charles A. Stuart, David Herndon, Robert R. Wolfe

Research output: Contribution to journalArticle

151 Citations (Scopus)

Abstract

Sepsis and extensive burn injury produce clinical syndromes characterized in part by "insulin resistance," but it is unclear if these insulin resistant states are identical. To test if the maximal biological effectiveness of insulin is altered in septic or burned patients, eight septic patients and eight nonseptic patients recovering from severe burn injury were studied using the hyperinsulinemic eukalemic euglycemic clamp technique. Compared with bed-rested controls, the septic patients showed an insulin-induced plasma clearance of potassium, which was 183% higher (P < .001), and a concomitant glucose clearance, which was 52% lower (P < .001). Nonseptic burn patients also had a 91% increase in potassium clearance (P < .05), but their maximal insulin-stimulated glucose uptake was not different from that of bedrested controls. When septic patients were compared with their nonseptic burned counterparts, there was no difference in potassium clearance in response to insulin, but glucose uptake by the septic patients was 47% lower (P < .001). Insulin infusion completely suppressed hepatic glucose production in both septic patients and in nonseptic burn patients. The percent of whole body glucose uptake that was oxidized was not different between the septic patients and the nonseptic postburn patients in both the basal and insulin-stimulated states (38% and 51% v 38% and 42%, respectively). It is concluded that septic and postburn insulin resistance differ in that peripheral glucose uptake in sepsis, but not nonseptic burn injury, is refractory to pharmacologic insulin stimulation, whereas in both states insulin effectively stimulates potassium uptake.

Original languageEnglish (US)
Pages (from-to)983-989
Number of pages7
JournalMetabolism
Volume38
Issue number10
DOIs
StatePublished - 1989

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Insulin Resistance
Insulin
Glucose
Potassium
Sepsis
Wounds and Injuries
Glucose Clamp Technique
Liver

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Shangraw, R. E., Jahoor, F., Miyoshi, H., Neff, W. A., Stuart, C. A., Herndon, D., & Wolfe, R. R. (1989). Differentiation between septic and postburn insulin resistance. Metabolism, 38(10), 983-989. https://doi.org/10.1016/0026-0495(89)90010-3

Differentiation between septic and postburn insulin resistance. / Shangraw, Robert E.; Jahoor, Farook; Miyoshi, Hiroshi; Neff, William A.; Stuart, Charles A.; Herndon, David; Wolfe, Robert R.

In: Metabolism, Vol. 38, No. 10, 1989, p. 983-989.

Research output: Contribution to journalArticle

Shangraw, RE, Jahoor, F, Miyoshi, H, Neff, WA, Stuart, CA, Herndon, D & Wolfe, RR 1989, 'Differentiation between septic and postburn insulin resistance', Metabolism, vol. 38, no. 10, pp. 983-989. https://doi.org/10.1016/0026-0495(89)90010-3
Shangraw RE, Jahoor F, Miyoshi H, Neff WA, Stuart CA, Herndon D et al. Differentiation between septic and postburn insulin resistance. Metabolism. 1989;38(10):983-989. https://doi.org/10.1016/0026-0495(89)90010-3
Shangraw, Robert E. ; Jahoor, Farook ; Miyoshi, Hiroshi ; Neff, William A. ; Stuart, Charles A. ; Herndon, David ; Wolfe, Robert R. / Differentiation between septic and postburn insulin resistance. In: Metabolism. 1989 ; Vol. 38, No. 10. pp. 983-989.
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