Influence of metformin on glucose intolerance and muscle catabolism following severe burn injury

Dennis Gore, Steven Wolf, Arthur Sanford, David Herndon, Robert R. Wolfe

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background Data: Hyperglycemia and accelerated muscle catabolism have been shown to adversely affect immune response and survival. The purpose of this study was to determine the effect of metformin on glucose kinetics and muscle protein metabolism in severely burned patients and assess any potential benefit of metformin in this clinical setting. Methods: In a double-blind, randomized manner, 8 adult burn patients received metformin (850 mg every 8 hours X 7 days), while 5 burn patients received placebo. Infusions of 6,6d2 glucose, d5 phenylalanine, sequential muscle biopsies, and femoral arterial, venous blood sampling allowed determination of glucose and muscle protein kinetics. Measurements were obtained immediately prior and at the conclusion of 7 days of treatment (metformin versus placebo). All patients received enteral feeds of comparable amounts during study. Results: Patients receiving metformin had a significant decrease in their plasma glucose concentration, the rate of glucose production, and an increase in glucose clearance. Metformin administration was also associated with a significant increase in the fractional synthetic rate of muscle protein and improvement in net muscle protein balance. Glucose kinetics and muscle protein metabolism were not significantly altered in the patients receiving placebo. Conclusions: Metformin attenuates hyperglycemia and increases muscle protein synthesis in severely burned patients, thereby indicating a metabolic link between hyperglycemia and muscle loss following severe injury. Therefore, therapies that improve glucose tolerance such as metformin may be of clinical value in ameliorating muscle catabolism in critically injured patients.

Original languageEnglish (US)
Pages (from-to)334-342
Number of pages9
JournalAnnals of Surgery
Volume241
Issue number2
DOIs
StatePublished - Feb 2005

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Glucose Intolerance
Metformin
Muscle Proteins
Glucose
Muscles
Wounds and Injuries
Hyperglycemia
Placebos
Thigh
Phenylalanine
Small Intestine
Biopsy
Survival
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Influence of metformin on glucose intolerance and muscle catabolism following severe burn injury. / Gore, Dennis; Wolf, Steven; Sanford, Arthur; Herndon, David; Wolfe, Robert R.

In: Annals of Surgery, Vol. 241, No. 2, 02.2005, p. 334-342.

Research output: Contribution to journalArticle

Gore, Dennis ; Wolf, Steven ; Sanford, Arthur ; Herndon, David ; Wolfe, Robert R. / Influence of metformin on glucose intolerance and muscle catabolism following severe burn injury. In: Annals of Surgery. 2005 ; Vol. 241, No. 2. pp. 334-342.
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