Effects of Early Intensive Treatment with Insulin on Insulin Resistance and Beta Cell Function in Patients with Severe Burns

Objective:To explore the effect of early intensive treatment with insulin on insulin resistance(IR)and beta cell function in patients with severe burns.Methods:A total of 128 patients with severe burns from Jan 2010 to Jun 2013 were randomly divided into continuous subcutaneous insulin infusion(CSII)group and control group,with64 patients in each group.The CSII group received intensive treatment with insulin and the fasting blood glucose(FBG)was controlled within 5-6.1mmol/L.While the control group received the conventional treatment.FBG and fasting insulin(FINS)was tested before the treatment and at 1 d,3 d,7 d and 14 d after the treatment.Homeostasis model assessment(HOMA)was used to calculate the IR index(HOMA-IR)and HOMA beta cell function index(HBCI).Results:At 1 d,3 d,7 d after the treatment,the level of FBG in the CSII group was significantly lower than that in the control group(P0.05).At 3 d and 7 d after the treatment,the level of FINS in the CSII group was significantly lower than that in the control group(P0.05).Except for FBG in the control group at 3 d after the treatment,both groups had differences in FBG and FINS at each time point after the treatment compared with that before the treatment(P0.01).At 1 d,3 d,7 d after the treatment,HOMA-IR in the CSII group was significantly lower than that in the control group(P0.01),and both groups had differences in HOMA-IR at each time point after treatment compared with that before the treatment(P0.01).At 1 d,3 d,7 d after treatment,HBCI in the CSII group was significantly higher than that in the control group(P0.01),and HBCI in the control group at 1 d and 3 d after treatment was lower than that before treatment(P0.05).Conclusions:Early intensive treatment with insulin can effectively reduce hyperglycemia,hyperinsulinemia after the burning and stablize beta cell function.