Caspian Journal of Internal Medicine
1
Caspian J Intern Med
Medical Sciences
http://caspjim.com
1
admin
2008-6164
2008-6172
8
10.22088/cjim
14
8888
13
en
jalali
1400
10
1
gregorian
2022
1
1
13
1
online
1
fulltext
en
Effect of melatonin on stress-induced hyperglycemia and insulin resistance in critically-ill patients: A randomized double-blind, placebo-controlled clinical trial
Endocrinology
Endocrinology
Original Article
Original Article
<span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0000ff;"><strong><em>Background</em></strong><em>:</em> </span>Hyperglycemia is a common finding which is associated with increased mortality and morbidity among critically ill patients. There is currently no evidence that melatonin could improve stress induced hyperglycemia (SIH). In this study, we evaluated the effect of melatonin on blood sugar and insulin resistance (IR) in critically-ill patients.<br>
<span style="color:#0000ff;"><strong><em>Methods</em></strong><em>:</em> </span>104 critically-ill patients with SIH divided into two groups, receiving melatonin (6 mg BD for 3 days) or placebo. Changes of blood sugar, IR indices including homeostasis model assessment for insulin resistance and homeostasis model assessment adiponectin (HOMA-AD) ratios, Glasgow coma scale (GCS) were evaluated on the 4<sup>th</sup> day of melatonin prescription. On the 7<sup>Th day </sup>of study, changes of ventilator dependency and delirium were considered. Mortality and intensive care unit (ICU) stay were also compared between groups.<br>
<span style="color:#0000ff;"><strong><em>Results</em></strong><em>:</em></span> On day 4, patients in the melatonin group had significantly lower blood glucose and HMOA-IR level compared with the placebo group (P=0.04 and P=0.03, respectively) whereas HOMA-AD level did not differ significantly from placebo group (p>0.2). Also, we did not observe any significant difference in GCS level at this time between groups (p>0.2). On day 7, melatonin could not improve ventilator dependency and delirium significantly (p>0.2) and also could not reduce mortality and ICU stay in comparison with placebo (p>0.2, P=0.2, respectively).<br>
<span style="color:#0000ff;"><strong><em>Conclusion</em></strong><em>:</em></span> Melatonin supplementation showed positive effect on blood sugar and somehow insulin resistance whereas it could not improve ICU complications.</span></span>
stress induced hyperglycemia, insulin resistance, Melatonin, APACHE II, ICU
51
60
http://caspjim.com/browse.php?a_code=A-10-2077-1&slc_lang=en&sid=1
Fahimeh
Naderi-Behdani
fahime.naderi90@gmail.com
100319475328460033306
100319475328460033306
No
Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
Fatemeh
Heydari
fateme58@yahoo.com
100319475328460033307
100319475328460033307
No
Department of Anesthesiology and Critical Care Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
shahram
Ala
sh204ala@gmail.com
100319475328460033308
100319475328460033308
Yes
Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
Siavash
Moradi
d.smor86@yahoo.com
100319475328460033309
100319475328460033309
No
Educational Development Center, Mazandaran University of Medical Sciences, Sari, Iran
Saeid
Abediankenari
abedianlab@yahoo.co.uk
100319475328460033310
100319475328460033310
No
Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Hosein
Asgarirad
dr_asgarirad@yahoo.com
100319475328460033311
100319475328460033311
No
Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
Elmira
khodabakhsh
khodabakhsh64@gmail.com
100319475328460033312
100319475328460033312
No
Department of General Surgery, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran