The unexpected increase of serum insulin levels in patients soon after trauma.
Serum insulin values elevated above the normal fasting range, i.e., 19.0-43.4 microU/ml (mean 27.9 +/- 6.4) were found on admission in 18.2% of patients with various forms of acute injury. Concomitant mean serum glucose level was 184 +/- 59 mg/100 ml compared with 81 +/- 6 mg/100 ml found in overnight fasting normal subjects. In this group of patients, the mean and the highest insulin elevations above the control mean value were 170% (85 microU/ml) and 940% (290 microU/ml) respectively. In individuals admitted directly from the scene of an accident, the mean insulin increase was significantly smaller (95%; p less than 0.01) than in patients transferred from other hospitals-203% (68 microU/ml ) in contrast to 940% (290 microU/ml) found in the transfer subgroup. Mean serum glucose concentrations in both subgroups differed similarly (p less than 0.02). The magnitude of the insulin increase did not correlate with severity or type of injury but showed a strong dependence on the time elapsed following trauma. Strong hyperinsulinemia appears to be less detrimental to survival than severe hypoinsulinemia manifested with a very low insulin-to-glucose ratio. Since both forms of insulinemia may occur under similar clinical conditions, early routine determinations of serum insulin levels are recommended in order to introduce effective therapeutic measures.
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D006946:Hyperinsulinism / Q000097:blood*; D007328:Insulin / Q000097:blood*; D013997:Time Factors; D014947:Wounds and Injuries / Q000097:blood*
D001786:Blood Glucose; D007328:Insulin