Effects of intensive insulin therapy on non-specific inflammatory factors in patients of critical illness complicated with hyperglycemia

Abstract

Objective To observe the effects of intensive insulin therapy on C-reactive protein (CRP) ,interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α ) in the patients of critical illness complicated with hyperglycemia and its incidence of side effect. Methods Two hundred and nine patients of critical illness complicated with hyperglycemia were randomly divided into intensive insulin therapy group (106 patients,blood glucose maintained at a level of 4.4-6.1 mmol/L) and conventional insulin therapy group ( 103 patients, blood glucose maintained at a level of 9.0-11.1 mmol/L). Serum levels of CRP,TNF- α and IL-6 were determined on 0,24,48,72 h respectively after ICU admission. Results The levels of blood glucose of both groups reached the target level. The incidence rates of the hypoglycemia had no significant difference between two groups [6.60 % (7/106) vs. 4.76% ( 3/63 ),P > 0.05]. After 72 h treatment, serum level of CRP in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 24,48 and 72 h treatment, serum level of IL-6 in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 48 and 72 h treatment, serum level of TNF-αin intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05). Conclusion Intensive insulin therapy can significantly decrease the levels of non-specific inflammatory factors in patients of critical illness complicated with hyperglycemia, which brings beneficial effect to the patients. Key words: Insulin; Critical illness; C-reactive protein; Interleukin-6; Tumor necrosis factor-alpha