• Zhongzhen Zhu, Tian Hu, Zhanke Wang, Jin Wang, Rui Liu, Qianyong Yang, Xiaoyun Zhang, and Yuanyuan Xiong.
• The Department of Nosocomiology, The 94th Hospital of PLA, Nanchang, 330002, China.
• Am J Emerg Med. 2018 Feb 1; 36 (2): 202-207.

BackgroundInsulin, as an anti-inflammatory drug, could not be freely used in patients who experienced trauma according to the degree of inflammation, because of the side effect of hypoglycemia. In vivo experimental evidence is lacking concerning whether the effect is dosage dependent and whether it relies on controlling hyperglycemia.MethodsBy adjusting the dosage ratio of glucose and insulin, different dosages of insulin were used to treat severely scalded MODS rats to achieve uncontrolled or controlled hyperglycemia. One hundred forty rats with severe scalded were randomly divided into a hyperglycemia-controlled group, hyperglycemia-uncontrolled group, and control group. The levels of inflammation response indexes and major organ dysfunction indexes were measured and compared between groups.ResultsThe blood indexes of inflammatory response and major organ dysfunction did not show statistical difference between hyperglycemia-controlled groups (A) and uncontrolled groups (B) in the same dosage of insulin (all P>0.05). The blood indexes of inflammatory response and major organ dysfunction demonstrated statistical difference in different dosages of insulin with hyperglycemia-controlled groups (A1-A3 groups) and hyperglycemia-uncontrolled groups (B1-B3 groups) (all P<0.01). The higher dosage of insulin, the better effect of anti-inflammation and organ protection it would demonstrate with or without controlling hyperglycemia.ConclusionsThe effect of anti-inflammation and organ protection of insulin is dosage dependent in vivo; it does not rely on controlling hyperglycemia. Temporary traumatic hyperglycemia itself might not be detrimental to the body. Adjusting the ratio of insulin and glucose could provide a novel train of thought for freely treating patients with severe traumatic injury with different dosages of insulin according to the degree of inflammation.Copyright © 2017 Elsevier Inc. All rights reserved.

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