Diabetes, insulin, and development of acute lung injury

Shyoko Honiden, Michelle Ng Gong

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

OBJECTIVES: Recently, many studies have investigated the immunomodulatory effects of insulin and glucose control in critical illness. This review examines evidence regarding the relationship between diabetes and the development of acute lung injury/acute respiratory distress syndrome (ALI/ARDS), reviews studies of lung injury related to glycemic and nonglycemic metabolic features of diabetes, and examines the effect of diabetic therapies. DATA SOURCES AND STUDY SELECTION: A MEDLINE/PubMed search from inception to August 1, 2008, was conducted using the search terms acute lung injury, acute respiratory distress syndrome, hyperglycemia, diabetes mellitus, insulin, hydroxymethylglutaryl-CoA reductase inhibitors (statins), angiotensin-converting enzyme inhibitor, and peroxisome proliferator-activated receptors, including combinations of these terms. Bibliographies of retrieved articles were manually reviewed. DATA EXTRACTION AND SYNTHESIS: Available studies were critically reviewed, and data were extracted with special attention to the human and animal studies that explored a) diabetes and ALI; b) hyperglycemia and ALI; c) metabolic nonhyperglycemic features of diabetes and ALI; and d) diabetic therapies and ALI. CONCLUSIONS: Clinical and experimental data indicate that diabetes is protective against the development of ALI/ARDS. The pathways involved are complex and likely include effects of hyperglycemia on the inflammatory response, metabolic abnormalities in diabetes, and the interactions of therapeutic agents given to diabetic patients. Multidisciplinary, multifaceted studies, involving both animal models and clinical and molecular epidemiology techniques, are essential.

Original languageEnglish (US)
Pages (from-to)2455-2464
Number of pages10
JournalCritical Care Medicine
Volume37
Issue number8
DOIs
StatePublished - Aug 2009
Externally publishedYes

Fingerprint

Acute Lung Injury
Adult Respiratory Distress Syndrome
Hyperglycemia
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Insulin
Peroxisome Proliferator-Activated Receptors
Molecular Epidemiology
Information Storage and Retrieval
Bibliography
Lung Injury
Angiotensin-Converting Enzyme Inhibitors
PubMed
Critical Illness
MEDLINE
Diabetes Mellitus
Therapeutics
Animal Models
Glucose

Keywords

  • Acute lung injury
  • Acute respiratory distress syndrome
  • Diabetes mellitus
  • Hyperglycemia
  • Insulin

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Diabetes, insulin, and development of acute lung injury. / Honiden, Shyoko; Gong, Michelle Ng.

In: Critical Care Medicine, Vol. 37, No. 8, 08.2009, p. 2455-2464.

Research output: Contribution to journalArticle

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