Insulin Therapy Improves Protein Metabolism in the Critically Ill (Critical Care)

Critical illness, trauma and burns are associated with profound metabolic abnormalities of which protein catabolism, hyperglycemia and insulin resistance are hallmarks of these conditions. Increased protein breakdown and loss results in muscle wasting, weakness, and diminished functioning. Interestingly, hyperglycemia and insulin resistance augment catabolic responses. Insulin, which is routinely administered to critically ill patients to prevent excessive hyperglycemia also stimulates protein synthesis and prevents whole body protein loss. The present commentary highlights the results of a recent study published in Critical Care and discusses whether moderate insulin therapy is equally beneficial as conventional insulin therapy in preventing protein catabolism and loss.