Dysfunctional pancreatic beta-cells of critical stress play a more prominent role in the development of stress diabetes in critically burned Korean subjects.
The purposes of this study are to identify the predictive parameters for the development of stress-induced hyperglycemia and to investigate the glucose metabolic homeostasis in critically burned Korean subjects. We conducted a prospective cross-sectional study of adult patients with glucose management targeting fasting and postprandial blood glucose levels less than 140 and 200 mg/dL, respectively, in patients with unrecognized diabetes. Clinical and laboratory stress parameters and insulin secretory and sensitivity parameters were assessed. Stimulated C-peptide and 24-hour urinary free cortisol predicted new-onset stress diabetes requiring insulin therapy. The subjects requiring insulin therapy were leaner and more insulin sensitive than insulin-free subjects, without significance. Glycated hemoglobin, stimulated C-peptide, homeostasis model assessment of insulin resistance, and age had a significant influence on the mean daily dose of insulin. Our present data showed that Korean subjects with dysfunctional pancreatic beta-cells of critical stress are prone to become stress diabetic and require more insulin to control the hyperglycemia.
Byung-Wan
Lee
L
Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea. bwanlee@yuhs.ac
Jun
Hur
H
Yim
Hae-Jun
HJ
Park
Jae-Bong
JB
Woo
Heungjeong
H
Yoo
Hyung-Joon
HJ
D000328:Adult; D000704:Analysis of Variance; D044466:Asian People; D002056:Burns / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism / Q000503:physiopathology*; D019518:Postprandial Period; D011446:Prospective Studies; D013312:Stress, Physiological
D007328:Insulin