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dc.contributor.authorCrisman, M
dc.contributor.authorLucchetta, L
dc.contributor.authorLuethi, N
dc.contributor.authorCioccari, L
dc.contributor.authorLam, Q
dc.contributor.authorEastwood, GM
dc.contributor.authorBellomo, R
dc.contributor.authorMartensson, J
dc.date.accessioned2021-02-04T01:06:28Z
dc.date.available2021-02-04T01:06:28Z
dc.date.issued2017-05-12
dc.identifierpii: 10.1186/s13613-017-0274-5
dc.identifier.citationCrisman, M., Lucchetta, L., Luethi, N., Cioccari, L., Lam, Q., Eastwood, G. M., Bellomo, R. & Martensson, J. (2017). The effect of insulin administration on c-peptide in critically ill patients with type 2 diabetes. ANNALS OF INTENSIVE CARE, 7 (1), https://doi.org/10.1186/s13613-017-0274-5.
dc.identifier.issn2110-5820
dc.identifier.urihttp://hdl.handle.net/11343/259264
dc.description.abstractBACKGROUND: In critically ill patients with permissive hyperglycemia, it is uncertain whether exogenous insulin administration suppresses or enhances c-peptide secretion (a marker of pancreatic beta-cell response). We aimed to explore this effect in patients with type 2 diabetes. METHODS: We prospectively enrolled a cohort of 45 critically ill patients with type 2 diabetes managed according to a liberal glucose protocol (target blood glucose 10-14 mmol/l). We recorded the administration of insulin and oral hypoglycemic agents and measured plasma c-peptide as surrogate marker of endogenous insulin secretion on the first two consecutive days in ICU. RESULTS: Overall, 20 (44.4%) patients required insulin to achieve target blood glucose. Insulin-treated patients had higher glycated hemoglobin A1c, more premorbid insulin-requiring type 2 diabetes, and greater blood glucose levels but lower c-peptide levels on admission. Premorbid insulin-requiring diabetes was independently associated with lower admission c-peptide, whereas greater plasma creatinine was independently associated with higher levels. Increases in c-peptide were positively correlated with an increase in blood glucose both in patients who did (r = 0.54, P = 0.01) and did not (r = 0.56, P = 0.004) receive insulin. However, insulin administration was independently associated with a greater increase in c-peptide (P = 0.04). This association was not modified by the use of oral insulin secretagogues. CONCLUSIONS: C-peptide, a marker of beta-cell response, responds to and is influenced by glycemia and renal function in critically ill patients with type 2 diabetes. In addition, in our cohort, exogenous insulin administration was associated with a greater increase in c-peptide in response to hyperglycemia. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN12615000216516).
dc.languageEnglish
dc.publisherSPRINGER HEIDELBERG
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleThe effect of insulin administration on c-peptide in critically ill patients with type 2 diabetes
dc.typeJournal Article
dc.identifier.doi10.1186/s13613-017-0274-5
melbourne.affiliation.departmentMelbourne Medical School
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleAnnals of Intensive Care
melbourne.source.volume7
melbourne.source.issue1
dc.rights.licenseCC BY
melbourne.elementsid1209228
melbourne.contributor.authorBellomo, Rinaldo
melbourne.contributor.authorEastwood, Glenn
dc.identifier.eissn2110-5820
melbourne.accessrightsOpen Access


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