Patterns of exogenous insulin requirement reflect insulin sensitivity changes in trauma

Heather F. Pidcoke, Jose Salinas, Sandra M. Wanek, Marybeth Concannon, Florence Loo, Kelly L. Wirfel, John B. Holcomb, Steven Wolf, Charles E. Wade

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: We investigated patterns of blood glucose and exogenous insulin requirement in the intensive care unit, and questioned whether they reflect fluctuations in insulin activity. Methods: Records for burn intensive care unit patients with 7 days of glucose control with insulin were reviewed. Hourly blood glucose and insulin dose were matched for time collected and analyzed with linear and cosine regression. Frequency analysis identified recurring patterns. Results: Diurnal patterns of blood glucose and insulin requirement were noted (insulin troughs = noon; insulin peaks = midnight; glucose troughs = 5 am; glucose peaks = 5 pm). Average insulin requirement increased at a constant linear rate (slope = .013, r2 = .57, P ≤ .001). Conclusions: Diurnal patterns in blood glucose and insulin requirement mirror those of healthy subjects and may reflect persistence of normal variability in insulin activity. The 5-hour offset in peaks and troughs is suggestive of complex interplay between insulin availability and receptor sensitivity. The insulin requirement to blood glucose ratio increased, evidence that insulin resistance progresses over time.

Original languageEnglish (US)
Pages (from-to)798-803
Number of pages6
JournalAmerican Journal of Surgery
Volume194
Issue number6
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

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Insulin Resistance
Insulin
Wounds and Injuries
Blood Glucose
Glucose
Intensive Care Units
Insulin Receptor
Linear Models
Healthy Volunteers

Keywords

  • Circadian rhythm
  • Diurnal variation
  • Hyperglycemia
  • Insulin resistance
  • Insulin sensitivity
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Pidcoke, H. F., Salinas, J., Wanek, S. M., Concannon, M., Loo, F., Wirfel, K. L., ... Wade, C. E. (2007). Patterns of exogenous insulin requirement reflect insulin sensitivity changes in trauma. American Journal of Surgery, 194(6), 798-803. https://doi.org/10.1016/j.amjsurg.2007.08.022

Patterns of exogenous insulin requirement reflect insulin sensitivity changes in trauma. / Pidcoke, Heather F.; Salinas, Jose; Wanek, Sandra M.; Concannon, Marybeth; Loo, Florence; Wirfel, Kelly L.; Holcomb, John B.; Wolf, Steven; Wade, Charles E.

In: American Journal of Surgery, Vol. 194, No. 6, 01.12.2007, p. 798-803.

Research output: Contribution to journalArticle

Pidcoke, HF, Salinas, J, Wanek, SM, Concannon, M, Loo, F, Wirfel, KL, Holcomb, JB, Wolf, S & Wade, CE 2007, 'Patterns of exogenous insulin requirement reflect insulin sensitivity changes in trauma', American Journal of Surgery, vol. 194, no. 6, pp. 798-803. https://doi.org/10.1016/j.amjsurg.2007.08.022
Pidcoke, Heather F. ; Salinas, Jose ; Wanek, Sandra M. ; Concannon, Marybeth ; Loo, Florence ; Wirfel, Kelly L. ; Holcomb, John B. ; Wolf, Steven ; Wade, Charles E. / Patterns of exogenous insulin requirement reflect insulin sensitivity changes in trauma. In: American Journal of Surgery. 2007 ; Vol. 194, No. 6. pp. 798-803.
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