Dysfunctional pancreatic β-cells of critical stress play a more prominent role in the development of stress diabetes in critically burned Korean subjects

• Published in: Metabolism, clinical and experimental Vol. 59; no. 9; pp. 1307 - 1315
• Main Authors: Byung-Wan, Lee, Jun, Hur, Yim, Hae-Jun, Park, Jae-Bong, Woo, Heungjeong, Yoo, Hyung-Joon
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2010
• Subjects: Adult; Analysis of Variance; Asian Continental Ancestry Group; Burns - complications; Burns - metabolism; Burns - physiopathology; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - etiology; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Endocrinology & Metabolism; Female; Humans; Hyperglycemia - etiology; Hyperglycemia - metabolism; Hyperglycemia - physiopathology; Insulin - blood; Insulin Resistance; Insulin-Secreting Cells - metabolism; Male; Middle Aged; Pancreas - metabolism; Pancreas - physiopathology; Postprandial Period; Prospective Studies; Stress, Physiological
• ISSN: 0026-0495; 1532-8600; 1532-8600
• DOI: 10.1016/j.metabol.2009.11.022

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 β-cells of critical stress are prone to become stress diabetic and require more insulin to control the hyperglycemia.