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Journal : INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES

THE ROLE OF INTENSIVE INSULIN THERAPY ON SUPEROXIDE DISMUTASE (SOD), TUMOR NECROSIS FACTOR-? (TNF-?), AND INTERLEUKIN-6 (IL-6) ON HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS Wiryana, Made; Suastika, Ketut; Bagianto, Hari; Bakta, Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (148.55 KB)

Abstract

Hyperglycemia and insulin resistance are common in critically ill patientsin the ICU, although they have not previously had diabetes. It has been reportedthat pronounced hyperglycemia may lead to complications in such patients, andcause the reactive oxygen species (ROS) production, although controlled trial dataare still lacking. The current debatable issue, focusing on whether the intensiveinsulin therapy, aimed at normalizing blood glucose, may improvepatients’prognosis. Then, the debate is mainly about the time to start the therapy,and target of blood glucose level. Therefore, this research is mainly designed andaimed at knowing the difference between intensive insulin therapy andconventional insulin therapy on the increase of superoxide dismutase (SOD),decrease of cytokine production (TNF-? and IL-6), increase of albumin level, andevent of SIRSThis study was carried out in a randomly pre and post-test control groupdesign, involving 40 adult patients being nursed through the ICU Sanglah hospitalDenpasar. They were randomly assigned to receive intensive insulin therapy, inwhich blood glucose was decreased and maintained at the level between 80-110mg/dl, or conventional insulin therapy in which the insulin was infused only if theblood glucose level exceeded 215 mg/dl, decreased and maintained then at thelevel between 180-200 mg/dl.The result of the study showed that there was (1) significant increase ofSOD mean level (370. 70 vs 98.50 U/gHb, p=0.001); (2) no significant decreaseof TNF-? mean level; (3) significant decrease of IL-6 mean level (10.26 vs 2.25;p=0.023); (4) significant increase of albumin mean level ( 0.62 vs 0.22); (5)significant decrease of SIRS (10 % vs 40 %, p=0.000) on intensive insulin therapygroup compared to conventional insulin therapy group. It can be concluded thatintensive insulin therapy could maintain blood glucose level between 80 – 110mg/dl, increase SOD level, decrease IL-6 level, increase albumin level, anddecrease SIRS on hyperglycemia in critically ill ICU patients.
THE ROLE OF INTENSIVE INSULIN THERAPY ON SUPEROXIDE DISMUTASE (SOD), TUMOR NECROSIS FACTOR-? (TNF-?), AND INTERLEUKIN-6 (IL-6) ON HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS Wiryana, Made; Suastika, Ketut; Bagianto, Hari; Bakta, Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 1 Januari 2009
Publisher : Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (217.01 KB)

Abstract

Hyperglycemia and insulin resistance are common in critically ill patientsin the ICU, although they have not previously had diabetes. It has been reportedthat pronounced hyperglycemia may lead to complications in such patients, andcause the reactive oxygen species (ROS) production, although controlled trial dataare still lacking. The current debatable issue, focusing on whether the intensiveinsulin therapy, aimed at normalizing blood glucose, may improvepatients’prognosis. Then, the debate is mainly about the time to start the therapy,and target of blood glucose level. Therefore, this research is mainly designed andaimed at knowing the difference between intensive insulin therapy andconventional insulin therapy on the increase of superoxide dismutase (SOD),decrease of cytokine production (TNF-? and IL-6), increase of albumin level, andevent of SIRSThis study was carried out in a randomly pre and post-test control groupdesign, involving 40 adult patients being nursed through the ICU Sanglah hospitalDenpasar. They were randomly assigned to receive intensive insulin therapy, inwhich blood glucose was decreased and maintained at the level between 80-110mg/dl, or conventional insulin therapy in which the insulin was infused only if theblood glucose level exceeded 215 mg/dl, decreased and maintained then at thelevel between 180-200 mg/dl.The result of the study showed that there was (1) significant increase ofSOD mean level (370. 70 vs 98.50 U/gHb, p=0.001); (2) no significant decreaseof TNF-? mean level; (3) significant decrease of IL-6 mean level (10.26 vs 2.25;p=0.023); (4) significant increase of albumin mean level ( 0.62 vs 0.22); (5)significant decrease of SIRS (10 % vs 40 %, p=0.000) on intensive insulin therapygroup compared to conventional insulin therapy group. It can be concluded thatintensive insulin therapy could maintain blood glucose level between 80 – 110mg/dl, increase SOD level, decrease IL-6 level, increase albumin level, anddecrease SIRS on hyperglycemia in critically ill ICU patients.
Co-Authors - Yehezkiel - Yehezkiel, - Adinda Putra Pradhana Anak Agung Gde Agung Adistaya Andi Irawan Andi Kusuma Wijaya, Andi Christopher Ryalino Cynthia Dewi Sinardja Demoina, I Gede Patria Devina Martina Bumi Dewa Ayu Mas Shintya Dewi Dyah Kanya Wati Elisma Nainggolan, Elisma EM, Tjahya Aryasa Emkel Perangin Angin, Emkel Gede Semarawima, Gede Giovanni, Malvin Hari Bagianto Hartawan , I.G.A.G. Utara I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit Aribawa I Gusti Putu Sukrana Sidemen I Ketut Sinardja I Ketut Suastika I Ketut Wibawa Nada I Made Agus Kresna Sucandra I Made Bakta I Made Darma Junaedi, I Made I Made Gede Widnyana I Made Jawi I Made Prema Putra I Made Subagiartha I Nyoman Budi Hartawan I Nyoman Hariyasa Sanjaya I NYOMAN MANTIK ASTAWA I Putu Agus Surya Panji I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Bagus Alit Saputra Ida Bagus Gde Sujana Ida Bagus Gde Sujana, Ida Bagus Gde Ida Bagus Gede Suparyatha Ida Bagus Krisna Jaya Sutawan Ida Bagus Okta Ida Bagus Subanada IGNA Putra Arimbawa, IGNA Putra Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Ketut Semara Jaya, Ketut Semara Kristian Felix Wundiawan Kurnia, Prajnaariayi Prawira Kurniyanta, I P Kurniyanta, I Putu Made Adi Kusuma Made Agus Kresna Sucandra, Made Agus Kresna Made Widnyana Marilaeta Cindryani, Marilaeta Narakusuma, I Putu Fajar Ni Nyoman Sri Budayanti Ni Putu Novita Pradnyani, Ni Putu Ni Putu Wardani Pande Nyoman Kurniasari, Pande Panji, I PAS Pontisomaya Parami Putu Agus Surya Panji Putu Kurniyanta Putu Pramana Suarjaya Raka-Sudewi A. A. Satria Pinanditas S Sidemen, I.G.P.Sukrana Sonni Soetjipto, Sonni Stefanus Taofik Suarjaya, I PP Sucandra, I MK Suputra Widharma, I Gede Suranadi , I Wayan Sutawinaya, I Putu Tanuwijaya, Tommy M Tirta, Ian Tjahya Aryasa Tjahya Aryasa E M Tjokorda Gde Agung Senapathi Wahyu Antara K., I Gede Wardani, Dinar Kusuma Widnyana, I MG Widyana, I Made Gede