Mechanisms of Improved Wound Healing and Protein Synthesis of Insulin and Metformin
Status:
Terminated
Trial end date:
2019-04-23
Target enrollment:
Participant gender:
Summary
Massive pediatric burns are associated with a persistent and sustained hypermetabolic
response characterized by elevated levels of circulating catecholamine's, cortisol, and
glucagon's, which can cause extreme muscle wasting, immunodeficiency, and delay in wound
healing. Insulin and metformin have demonstrated anabolic activity with minimal associated
side effects. However, it is unknown whether the beneficial effects arise from tight
euglycemic control or direct effect of insulin action. We hypothesize that during acute
hospitalization, administration of metformin at a dose titrated to maintain blood glucose
between 80-180 mg/dl will accelerate wound healing and recovery in children with severe
thermal injury and will have beneficial long-term effects on muscle strength, immune
function, and wound healing.