Challenges of the intensive insulin therapy in experimental models of extensive burn injury

Hananiah Tardivo Quintana 1, *, Vivianne Izabelle de Araújo Baptista 2, Mariana Cruz Lazzarin 1 and Flavia de Oliveira 1

1 Department of Biosciences, Federal University of São Paulo, UNIFESP, SP, Brazil.
2 Multicampi School of Medical Sciences of the Rio Grande do Norte, Federal University of the Rio Grande do Norte, RN, Brazil.
 
Review Article
World Journal of Advanced Research and Reviews, 2020, 07(02), 034-044
Article DOI: 10.30574/wjarr.2020.7.2.0277
 
Publication history: 
Received on 23 July 2020; revised on 03 August 2020; accepted on 06 August 2020
 
Abstract: 
Burn injuries (BI) above 40% of total body surface area (TBSA) are considered extensive and associated to systemic responses. The intensive insulin therapy (IIT) has been chosen as treatment because of its anabolic and anti-inflammatory properties, and by glycemic control. Several experimental models of extensive BI with IIT has just been studied, however they have many variables and challenges. Thus, this review aims to investigate the animal models of extensive BI with IIT, in order to better understanding benefits and limitations of this therapy. The review of papers published on the literature and indexed on the PubMed database was conducted by searching the keywords predetermined. Insulin administration after BI is able to revert hyperglycemia state, accelerate wound healing, decrease the mRNA expression of some pro-inflammatory cytokines, attenuate acute lung injuries, decrease inflammation in intestinal epithelium and attenuate the muscle loss. We can conclude, although there are limitations related to burn standard or insulin administration, the systemic benefits of ITT overcome limitations. 
 
Keywords: 
Burn; Insulin; Metabolism; Intensive insulin therapy; Insulin resistance.
 
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