title: Intensive insulin therapy in severe acute pancreatitis: a meta-analysis and systematic review.
abstract: OBJECTIVE
  To assess the effect of intensive insulin therapy on outcomes of patients with severe acute pancreatitis.
  
  
  METHODS
  Relevant literatures cited in these electronic databases: Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure (CNK1) database, and Excerpta Medical database (Embase) were systematically searched for randomized controlled trials (RCTs) in which intensive insulin therapy was used in severe acute pancreatitis. Length of hospitalization, acute physiology and chronic health evaluation II (APACHE II) score, incidence of complications, and adverse effects were recorded for statistical analysis. The methodological quality of the eligible studies was assessed by Jadad scale. The results were analysed by Revman 4.3 software.
  
  
  RESULTS
  Three studies, which included a total of 118 cases, were finally reviewed. The methodological quality of the trials varied substantially In patients with severe acute pancreatitis, intensive insulin therapy was associated with shorter length of hospitalization (weighted mean difference (WMD) = -12.13, 95% confidence interval (CI) [-15.48, 8.78], p > 0.00001) and lower APACHE II score after 72 hours treatment (WMD = -3.80, 95% CI [-4.88,2. 72], p > 0.00001). One study reported insulin-related adverse event.
  
  
  CONCLUSIONS
  In patients with severe acute pancreatitis, intensive insulin therapy could relieve the patient's condition earlier and shorten the length of hospitalization without serious adverse effect.
authors: Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors: J
authors: J
authors: Li
authors: T R
authors: TR
authors: Chen
authors: H L
authors: HL
authors: Gong
authors: M H
authors: MH
authors: Wan
authors: G Y
authors: GY
authors: Chen
authors: W F
authors: WF
authors: Tang
mesh_terms: D018806:APACHE; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007902:Length of Stay; D010195:Pancreatitis / Q000188:drug therapy*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin