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Original communication| Volume 79, ISSUE 2, P177-181, February 1976

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The effect of severe trauma on urine loss of insulin

  • Michael M. Meguid
    Correspondence
    Reprint requests: Michael M. Meguid, M.D., Department of Surgery, University Hospital, Boston University Medical Center, Suite 203, 720 Harrison Ave., Boston, Mass. 02118.
    Affiliations
    From the Department of Surgery and the Department of Medicine, Harvard Medical School at the Peter Bent Brigham Hospital, Boston, Mass., USA

    From the Joslin Research Laboratory, Boston, Mass., USA
    Search for articles by this author
  • Frederico Aun
    Affiliations
    From the Department of Surgery and the Department of Medicine, Harvard Medical School at the Peter Bent Brigham Hospital, Boston, Mass., USA

    From the Joslin Research Laboratory, Boston, Mass., USA
    Search for articles by this author
  • J.Stuart Soeldner
    Affiliations
    From the Department of Surgery and the Department of Medicine, Harvard Medical School at the Peter Bent Brigham Hospital, Boston, Mass., USA

    From the Joslin Research Laboratory, Boston, Mass., USA
    Search for articles by this author
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      Abstract

      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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