title: Tight glycemic control by insulin, started in the preischemic, but not postischemic, period, protects against ischemic spinal cord injury in rabbits.
abstract: BACKGROUND
  It is not well established whether insulin protects against ischemic spinal cord injury. We examined the effects of a single dose of insulin that corrects mild hyperglycemia on the outcome after transient spinal cord ischemia in rabbits.
  
  
  METHODS
  We assigned rabbits to four groups (n = 8 in each); untreated control (C) group, preischemic insulin (Pre-I) group, preischemic insulin with glucose (GI) group (glucose concentrations were maintained at levels similar to the C group by the administration of glucose), and postischemic insulin (Post-I) group. Insulin (0.5 IU/kg) was administered 30 min before ischemia in the Pre-I and GI groups, and just after reperfusion in the Post-I group. Spinal cord ischemia was produced by occluding the abdominal aorta for 13 min. Neurologic and histopathologic evaluations were performed 7 days after ischemia.
  
  
  RESULTS
  The mean blood glucose concentration before ischemia in the Pre-I group (118 mg/dL) was significantly lower than in the other three groups (158-180 mg/dL) and those of 30 min after reperfusion in the Pre-I (92 mg/dL) and Post-I (100 mg/dL) groups were significantly lower than in the C (148 mg/dL) and GI (140 mg/dL) groups. The motor function score and number of normal neurons in the anterior lumbar spinal cord in the Pre-I group were significantly greater than in the other three groups.
  
  
  CONCLUSIONS
  These results suggest that a relatively small dose of preischemic insulin protects against ischemic spinal cord injury, and that the protective effects result from tight glycemic control before ischemia.
authors.affiliation: Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nagamizo
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tsuruta
authors.forename: Mishiya
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matayoshi
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yamashita
authors.forename: Takefumi
authors.initials: T
authors.lastname: Sakabe
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D038321:Glycemic Index / Q000187:drug effects* / Q000502:physiology; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use*; D019194:Ischemic Preconditioning / Q000379:methods; D011817:Rabbits; D020760:Spinal Cord Ischemia / Q000097:blood* / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin