To study the effect of
indomethacin on insulin
sensitivity and glycometabolism. Patients with severe intraabdominal infection(APACHE
II score >10, glucose concentration >10 mmol/L) were selected and divided into two groups: Control( n =8) and INDO( n =7) groups. Patients in both groups were infused with insulin (32U/d), whereas
indomethacin was put into rectum (100mg/d) of INDO patients. Samples and assessment were taken on d0 and d5, fasting blood glucose ,Cr ,BUN,TG,FFA were assayed and energy expenditure ,substrates oxidation rate were measured by indirect calorimetry, and insulin tolerance test was made on d5. Five days after insulin infusion , blood Cr, BUN, TG,FFA decreased and glucose oxidation rate increased to some degree in patients of both groups, but they were significantly higher on d1 than d5 in INDO group ( P <0.05). No antihyperglycemia effect of insulin infusion was found in septic patients, whereas significant reduction was found in blood glucose ( P <0.05). Result of insulin tolerance test showed that glucose decreased significantly after insulin injection in INDO group ,which had a higher KI value than that in control group. CONCLUSIONS Indomethacin could enhance insulin
sensitivity, promote glucose utilization and improve glucose metabolism in severe septic patients.