A submaximal dose of insulin promotes net skeletal muscle protein synthesis in patients with severe burns

Arny A. Ferrando, David L. Chinkes, Steven E. Wolf, Sina Matin, David N. Herndon, Robert R. Wolfe

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

Objective: To investigate the hypothesis that a submaximal insulin dose reverses the net muscle catabolism associated with severe burns, and to determine its effects on amino acid kinetics. Summary Background Data: The authors previously showed that a maximal dose of insulin administered to patients with severe burns promoted skeletal muscle glucose uptake and net protein synthesis. However, this treatment was associated with caloric overload resulting from the large quantities of exogenous glucose required to maintain euglycemia, and hypoglycemia was a potential problem. Methods: Thirteen patients were studied after severe burn injury (>60% total body surface area). Patients were randomly treated by standard care (n = 5) or with exogenous insulin (n = 8). Data were derived from an arteriovenous model with primed-continuous infusions of stable isotopes and biopsies of the vastus lateralis muscle. Results: Net amino acid balance was significantly improved with insulin treatment. Skeletal muscle protein synthesis was significantly greater in the group receiving insulin, whereas muscle protein breakdown was not different between the groups. This submaximal dose of insulin did not affect glucose or amino acid uptake or require a greater caloric intake to avoid hypoglycemia. Conclusions: Submaximal insulin can promote muscle anabolism without eliciting a hypoglycemic response.

Original languageEnglish (US)
Pages (from-to)11-18
Number of pages8
JournalAnnals of Surgery
Volume229
Issue number1
DOIs
StatePublished - Jan 1999

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Muscle Proteins
Burns
Skeletal Muscle
Insulin
Hypoglycemia
Amino Acids
Glucose
Muscles
Body Surface Area
Quadriceps Muscle
Energy Intake
Hypoglycemic Agents
Isotopes
Biopsy
Wounds and Injuries
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

A submaximal dose of insulin promotes net skeletal muscle protein synthesis in patients with severe burns. / Ferrando, Arny A.; Chinkes, David L.; Wolf, Steven E.; Matin, Sina; Herndon, David N.; Wolfe, Robert R.

In: Annals of Surgery, Vol. 229, No. 1, 01.1999, p. 11-18.

Research output: Contribution to journalArticle

Ferrando, Arny A. ; Chinkes, David L. ; Wolf, Steven E. ; Matin, Sina ; Herndon, David N. ; Wolfe, Robert R. / A submaximal dose of insulin promotes net skeletal muscle protein synthesis in patients with severe burns. In: Annals of Surgery. 1999 ; Vol. 229, No. 1. pp. 11-18.
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