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Insulin therapy for hyperglycemia in neonatal sepsis using a preterm mouse model
Author(s) -
Miyauchi Harunori,
Fujioka Kazumichi,
Okubo Saki,
Nishida Kosuke,
Ashina Mariko,
Ikuta Toshihiko,
Okata Yuichi,
Maeda Kosaku,
Iijima Kazumoto,
Bitoh Yuko
Publication year - 2020
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.14126
Subject(s) - medicine , sepsis , insulin , stress hyperglycemia , endocrinology , basal (medicine) , oxidative stress , immunosuppression , neonatal sepsis
Background Stress‐induced hyperglycemia is a frequent complication of neonatal sepsis. Hyperglycemia induces oxidative stress and immunosuppression. We investigated the glucose kinetics and effect of insulin administration during stress‐induced hyperglycemia in a neonatal sepsis mouse model. Methods A stock cecal slurry (CS) solution was prepared from adult cecums and 3.0 mg of CS/g (LD 40 ) was administered intraperitoneally to 4‐day‐old FVB mouse pups. Blood glucose levels were measured at 1.5, 3, 6, and 9 h post‐sepsis induction and compared with basal levels. Two different doses of ultrafast‐acting insulin were administered subcutaneously, and blood glucose levels and survival rates were monitored. Results Blood glucose levels were significantly higher than those of baseline levels with a peak at 3 h, which progressively decreased from 6 to 9 h post‐sepsis induction. Insulin treatment reduced post‐sepsis‐induced hyperglycemia at 1.5 and 3 h. The mortality rate of CS‐only pups (39%) was similar to that of CS + 1 U/kg insulin pups (60%). However, the mortality rate of CS + 5 U/kg insulin pups (82%) was significantly higher than that of CS‐only pups. Conclusions Marked hyperglycemia was induced immediately after post‐sepsis induction, and the high‐dose insulin treatment increased mortality post‐induction. Stress‐induced hyperglycemia could therefore be a physiological and protective response for preterm sepsis, and aggressive treatment of this hyperglycemia might be contraindicated.