Abstract
Reported here is our experience with a severe burn patient complicated with diabetes mellitus whose blood glucose level was controlled by artificial pancreas. A 70-year-old woman had been under insulin therapy for diabetes mellitus. She became unconscious while taking a bath at home. The bath continued to fill with hot water, and she suffered burns covering 40% total body surface area (TBSA). Enteral feeding was started soon after injury, but the patient developed complication of sepsis and blood glucose was poorly controlled, so artificial pancreas was introduced on day 6. Blood glucose level was favorably controlled around 150 mg/dl thereafter, and intake of the targeted nutrition became possible. Artificial pancreas enabled tight glucose control without inducing hypoglycemic attack, and the required dose of insulin was evident, thereby facilitating blood glucose control after withdrawal. Initiation of enteral feeding at early stage is recommended for burn patients from the viewpoint of suppressing hypercatabolic protein. However, blood glucose control is often difficult in patients complicated with diabetes mellitus, due to aggravation of insulin resistance triggered by injury. Artificial pancreas was considered a very useful tool for such a patient.
