Insulin infusion in acute illness

The discovery of the antiinflammatory effect of insulin and the proinflammatory effect of glucose has not only provided novel insight into the mechanisms underlying several disease states but has also provided a rationale for the treatment of hyperglycemia in several acute clinical conditions. Van d...

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Bibliographic Details
Published in:The Journal of clinical investigation 2005-08, Vol.115 (8), p.2069-2072
Main Authors: Dandona, Paresh, Mohanty, Priya, Chaudhuri, Ajay, Garg, Rajesh, Aljada, Ahmad
Format: Article
Language:English
Subjects:
Acute Disease
Animals
Biomedical research
Blood Glucose - drug effects
Hepatocytes - metabolism
Humans
Hyperglycemia - drug therapy
Hyperglycemia - metabolism
Inflammation - drug therapy
Inflammation - metabolism
Insulin - administration & dosage
Nitric Oxide - blood
Nitric Oxide Synthase - metabolism
Nitric Oxide Synthase Type II
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Summary:The discovery of the antiinflammatory effect of insulin and the proinflammatory effect of glucose has not only provided novel insight into the mechanisms underlying several disease states but has also provided a rationale for the treatment of hyperglycemia in several acute clinical conditions. Van den Berghe et al. previously showed the benefits of intensive glycemic control with insulin in patients admitted to intensive care units. In this issue of the JCI, the same group of investigators now demonstrates that infusion of insulin to restore euglycemia in these patients results in a marked reduction in inflammatory indices such as adhesion molecules, hepatic iNOS, and plasma NO metabolites. The reduction in the mediators of inflammation may thus be responsible for the impressive improvement in clinical outcomes following insulin therapy, and the results suggest a new paradigm in which glucose and insulin are related not only through their metabolic actions but also through their opposite effects on inflammatory mechanisms.
ISSN:0021-9738
1558-8238
DOI:10.1172/JCI26045