Insulin resistance, secretion and breakdown are increased 9 months following severe burn injury

Melanie G. Cree, Ricki Y. Fram, David Barr, David Chinkes, Robert R. Wolfe, David Herndon

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Insulin resistance in the acute burn period has been well described, however, it is unknown if alterations in glucose metabolism persist beyond discharge from the acute injury. To measure the duration of insulin resistance following recovery from the acute burn injury, we performed a prospective cross-sectional study with a standard 2-h oral glucose tolerance test in 46 severely burned children at 6, 9 or 12 months following initial injury. Glucose uptake and insulin secretion were assessed following the glucose load. Results were compared to those previously published in healthy children. At 6 months after burn, the 2-h glucose concentration was significantly (P < 0.001) greater than controls, and the area under the curve (AUC) of glucose was significantly higher compared to 12 months and to healthy children (P = 0.027 and P < 0.001, respectively). The 9-month AUC glucose was higher than controls (P < 0.01). The 6-month 2-h insulin was significantly higher than controls, as was the AUC of insulin in all time points post-burn. The AUC of C-peptide was significantly greater at 6 months after injury compared to 9 and 12 months (P < 0.01 for both). Increased 2 h and AUC glucose and insulin indicate that glucose metabolism is still affected at 6 and 9 months after injury, and coincides with previously documented defects in bone and muscle metabolism at these time points. Insulin breakdown is also still increased in this population. Further study of this population is warranted to determine if specific treatment is needed.

Original languageEnglish (US)
Pages (from-to)63-69
Number of pages7
JournalBurns
Volume35
Issue number1
DOIs
StatePublished - Feb 2009

Fingerprint

Insulin Resistance
Glucose
Area Under Curve
Wounds and Injuries
Insulin
C-Peptide
Glucose Tolerance Test
Burns
Population
Cross-Sectional Studies
Bone and Bones
Muscles

Keywords

  • Burns
  • Insulin resistance
  • OGTT
  • Pediatrics

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Cree, M. G., Fram, R. Y., Barr, D., Chinkes, D., Wolfe, R. R., & Herndon, D. (2009). Insulin resistance, secretion and breakdown are increased 9 months following severe burn injury. Burns, 35(1), 63-69. https://doi.org/10.1016/j.burns.2008.04.010

Insulin resistance, secretion and breakdown are increased 9 months following severe burn injury. / Cree, Melanie G.; Fram, Ricki Y.; Barr, David; Chinkes, David; Wolfe, Robert R.; Herndon, David.

In: Burns, Vol. 35, No. 1, 02.2009, p. 63-69.

Research output: Contribution to journalArticle

Cree, MG, Fram, RY, Barr, D, Chinkes, D, Wolfe, RR & Herndon, D 2009, 'Insulin resistance, secretion and breakdown are increased 9 months following severe burn injury', Burns, vol. 35, no. 1, pp. 63-69. https://doi.org/10.1016/j.burns.2008.04.010
Cree, Melanie G. ; Fram, Ricki Y. ; Barr, David ; Chinkes, David ; Wolfe, Robert R. ; Herndon, David. / Insulin resistance, secretion and breakdown are increased 9 months following severe burn injury. In: Burns. 2009 ; Vol. 35, No. 1. pp. 63-69.
@article{ed22871935434fc2a1e279baf8093209,
title = "Insulin resistance, secretion and breakdown are increased 9 months following severe burn injury",
abstract = "Insulin resistance in the acute burn period has been well described, however, it is unknown if alterations in glucose metabolism persist beyond discharge from the acute injury. To measure the duration of insulin resistance following recovery from the acute burn injury, we performed a prospective cross-sectional study with a standard 2-h oral glucose tolerance test in 46 severely burned children at 6, 9 or 12 months following initial injury. Glucose uptake and insulin secretion were assessed following the glucose load. Results were compared to those previously published in healthy children. At 6 months after burn, the 2-h glucose concentration was significantly (P < 0.001) greater than controls, and the area under the curve (AUC) of glucose was significantly higher compared to 12 months and to healthy children (P = 0.027 and P < 0.001, respectively). The 9-month AUC glucose was higher than controls (P < 0.01). The 6-month 2-h insulin was significantly higher than controls, as was the AUC of insulin in all time points post-burn. The AUC of C-peptide was significantly greater at 6 months after injury compared to 9 and 12 months (P < 0.01 for both). Increased 2 h and AUC glucose and insulin indicate that glucose metabolism is still affected at 6 and 9 months after injury, and coincides with previously documented defects in bone and muscle metabolism at these time points. Insulin breakdown is also still increased in this population. Further study of this population is warranted to determine if specific treatment is needed.",
keywords = "Burns, Insulin resistance, OGTT, Pediatrics",
author = "Cree, {Melanie G.} and Fram, {Ricki Y.} and David Barr and David Chinkes and Wolfe, {Robert R.} and David Herndon",
year = "2009",
month = "2",
doi = "10.1016/j.burns.2008.04.010",
language = "English (US)",
volume = "35",
pages = "63--69",
journal = "Burns",
issn = "0305-4179",
publisher = "Elsevier Limited",
number = "1",

}

TY - JOUR

T1 - Insulin resistance, secretion and breakdown are increased 9 months following severe burn injury

AU - Cree, Melanie G.

AU - Fram, Ricki Y.

AU - Barr, David

AU - Chinkes, David

AU - Wolfe, Robert R.

AU - Herndon, David

PY - 2009/2

Y1 - 2009/2

N2 - Insulin resistance in the acute burn period has been well described, however, it is unknown if alterations in glucose metabolism persist beyond discharge from the acute injury. To measure the duration of insulin resistance following recovery from the acute burn injury, we performed a prospective cross-sectional study with a standard 2-h oral glucose tolerance test in 46 severely burned children at 6, 9 or 12 months following initial injury. Glucose uptake and insulin secretion were assessed following the glucose load. Results were compared to those previously published in healthy children. At 6 months after burn, the 2-h glucose concentration was significantly (P < 0.001) greater than controls, and the area under the curve (AUC) of glucose was significantly higher compared to 12 months and to healthy children (P = 0.027 and P < 0.001, respectively). The 9-month AUC glucose was higher than controls (P < 0.01). The 6-month 2-h insulin was significantly higher than controls, as was the AUC of insulin in all time points post-burn. The AUC of C-peptide was significantly greater at 6 months after injury compared to 9 and 12 months (P < 0.01 for both). Increased 2 h and AUC glucose and insulin indicate that glucose metabolism is still affected at 6 and 9 months after injury, and coincides with previously documented defects in bone and muscle metabolism at these time points. Insulin breakdown is also still increased in this population. Further study of this population is warranted to determine if specific treatment is needed.

AB - Insulin resistance in the acute burn period has been well described, however, it is unknown if alterations in glucose metabolism persist beyond discharge from the acute injury. To measure the duration of insulin resistance following recovery from the acute burn injury, we performed a prospective cross-sectional study with a standard 2-h oral glucose tolerance test in 46 severely burned children at 6, 9 or 12 months following initial injury. Glucose uptake and insulin secretion were assessed following the glucose load. Results were compared to those previously published in healthy children. At 6 months after burn, the 2-h glucose concentration was significantly (P < 0.001) greater than controls, and the area under the curve (AUC) of glucose was significantly higher compared to 12 months and to healthy children (P = 0.027 and P < 0.001, respectively). The 9-month AUC glucose was higher than controls (P < 0.01). The 6-month 2-h insulin was significantly higher than controls, as was the AUC of insulin in all time points post-burn. The AUC of C-peptide was significantly greater at 6 months after injury compared to 9 and 12 months (P < 0.01 for both). Increased 2 h and AUC glucose and insulin indicate that glucose metabolism is still affected at 6 and 9 months after injury, and coincides with previously documented defects in bone and muscle metabolism at these time points. Insulin breakdown is also still increased in this population. Further study of this population is warranted to determine if specific treatment is needed.

KW - Burns

KW - Insulin resistance

KW - OGTT

KW - Pediatrics

UR - http://www.scopus.com/inward/record.url?scp=58149129984&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58149129984&partnerID=8YFLogxK

U2 - 10.1016/j.burns.2008.04.010

DO - 10.1016/j.burns.2008.04.010

M3 - Article

VL - 35

SP - 63

EP - 69

JO - Burns

JF - Burns

SN - 0305-4179

IS - 1

ER -