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Six trauma patients and five healthy volumteers were given an intravenous glucose infusion (5 Gm. per hour) for 6 hours. The serum insulin response and urine insulin excretion were measured and compared in the two groups. Glucose intolerance and serum insulin levels which were elevated but inappropriately low for the degree of glycemia characterized the trauma patients. Urine insulin concentrations and total urine insulin were increased significantly in the trauma patients. Renal function was similar in both groups, as determined by serum creatinine, blood urea nitrogen, and creatinine clearance. The increase in urine insulin concentration in the trauma patients reflected the higher serum insulin concentrations, but no correlation existed between serum insulin and urine insulin concentrations. A negative correlation was found between “insulin clearance” and serum insulin in both groups, indicating altered renal handling of insulin following injury which may be a contributory factor to the relative hypoinsulinemia of trauma.
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- Analysis of urinary excretion of insulin in the normal dog.Arch. Int. Pharmacodyn. Ther. 1967; 167: 480
- Insulin uptake in the renal proximal tubule.Am. J. Physiol. 1973; 225: 1399
- Inhibition of insulin release during hypovolemic shock.Metabolism. 1973; 22: 1449
- The renal handling of insulin.J. Clin. Invest. 1967; 46: 911
- Renal tubular protein absorption in the rat.J. Clin. Invest. 1970; 49: 1
- The disciplining of medical data.Br. Med. Bull. 1968; 24: 210
- Direct measurement of insulin secretory rate.Ann. Surg. 1972; 176: 296
- Effect of traumatic shock on plasma catecholamine levels in man.Ann. Clin. Res. 1972; 4: 204
- Immunoassay of insulin in human urine.Acta Endocrinol. 1966; 51: 400
- Evaluation of the double antibody radioimmunoassay of insulin in plasma and urine in normal subjects.Acta Endocrinol. 1969; 60: 327
- Renal handling of insulin and growth hormone in hemorrhagic shock.Surgery. 1969; 66: 175
- Norepinephrine: Key hormone in post-traumatic utilization of body fuel?.Clin. Res. 1974; 22: 475A
- Hormone-substrate interrelationships in trauma.Arch. Surg. 1974; 109: 776
- Urinary excretion of insulin by normal and diabetic subjects.J. Clin. Invest. 1948; 27: 515
- Metabolism of insulin-I131 and glucagon-I131 in the kidney of the rat.Am. J. Physiol. 1958; 192: 227
- Abnormal carbohydrate metabolism in renal failure.Metabolism. 1965; 14: 1294
- Control of insulin secretion by catecholamines, stress and the sympathetic nervous system.in: ed. 4. Fed. Proc. 32. 1973: 1792
- The renal uptake and excretion of insulin in the dog.J. Lab. Clin. Med. 1969; 73: 893
- Urine insulin in normal subjects.Metabolism. 1967; 16: 234
- Urine insulin in renal disease.J. Lab. Clin. Med. 1970; 75: 998
- Critical variables in the radioimmunoassay of serum insulin using the double antibody technique.Diabetes. 1965; 14: 771
- Increased urinary clearance of albumin, B2 microglobulin, insulin and luteinizing hormone following surgical or accidental trauma.Scand. J. Lab. Invest. 1972; 30: 275
- Degradation of insulin-I131 and glucagon-I131 and factors influencing it.Ann. N. Y. Acad. Sci. 1959; 74: 513
- The role of the kidney in the disposal of radioiodinated sodium and non-radioiodinated insulin in dogs.Diabetes. 1966; 15: 680
Accepted: August 25, 1975
☆Supported by National Institutes of Health Grant AM-09748, United States Army Research and Development Command, the Upjohn Company, Kalamazoo, Mich., and the Joslin Diabetes Foundation, Inc., Boston, Mass.
© 1976 Published by Elsevier Inc.