A proof of concept study

The insulin stress response theory has been formulated following preliminary human clinical research in patients undergoing elective orthopaedic surgery. This clinical setting provides suitable conditions where insulin secretion may be studied following a planned surgical operation. In particular, the clinical setting of elective surgery allows the comparison between unstressed and stressed conditions during the course of planned elective orthopaedic surgery where stressed conditions occur immediately following surgery. 

This clinical setting is important as the insulin stress response can only be demonstrated by measuring the change in fasting insulin concentrations between the unstressed to stressed states. This change in concentration can then be confirmed by measuring the change in fasting insulin concentration from the stressed state back to the resting unstressed state following recovery from surgery.

The insulin stress response theory to acute tissue injury proposes a characterisitc change in fasting insulin concentrations from the resting unstressed  state to the stressed state. This change in concentration is assumed to peak at 24 hours post injury. The fasting insulin concentration in the blood in the stressed state then returns to the fasting resting unstressed state over the next 42 hours following injury. This change in fasting insulin concentration can be represented graphically by a concentration time curve shown in Fig 1.

The insulin stress response theory therefore postulates a characteristic stress response pattern in fasting insulin concentrations over the first 72 hours period following any life-threatening injury. Further research is required to confirm these important preliminary research findings which were obtained using ad hoc analysis. As outlined within this website, the strength of the statistical analysis from these preliminary findings is supported by similar stress response patterns that were observed in metabolic mediators that are known to regulate insulin secretion by the pancreas. The preliminary findings are outlined in section X