Challenges of the intensive insulin therapy in experimental models of extensive burn injury

Burn injuries (BI) above 40% of total body surface area (TBSA) are considered extensive and associated to systemic responses. The intensive insulin therapy (IIT) has been chosen as treatment because of its anabolic and anti-inflammatory properties, and by glycemic control. Several experimental models of extensive BI with IIT has just been studied, however they have many variables and challenges. Thus, this review aims to investigate the animal models of extensive BI with IIT, in order to better understanding benefits and limitations of this therapy. The review of papers published on the literature and indexed on the PubMed database was conducted by searching the keywords predetermined. Insulin administration after BI is able to revert hyperglycemia state, accelerate wound healing, decrease the mRNA expression of some pro-inflammatory cytokines, attenuate acute lung injuries, decrease inflammation in intestinal epithelium and attenuate the muscle loss. We can conclude, although there are limitations related to burn standard or insulin administration, the systemic benefits of ITT overcome limitations.