Problem Statement

Is it recognized that the burn injury is exacerbating the hyperglycemic state.

Question

I am in the outback of Australia and had a burn wound from open fire exposure two days ago. Now I feel similar to hyperglycemic state as I also have diabetes and know the symptoms for hyperglycemia. Can that be? What should I do?

Answer

It is indeed possible that your burn injury is exacerbating your hyperglycemic state, especially given your pre-existing diabetes. Burns can induce a hypermetabolic state that affects glucose metabolism, leading to insulin resistance and hyperglycemia. This is a well-documented phenomenon in the literature, where burn patients, particularly those with severe injuries, can experience significant alterations in their glucose metabolism [31-34].

Here are the steps you should take:

1. Monitor Blood Glucose Levels: It's crucial to frequently monitor your blood glucose levels to assess the severity of your hyperglycemia. If you have a glucose meter with you, use it according to the manufacturer's instructions.
2. Hydration: Ensure you are well-hydrated, as dehydration can worsen hyperglycemia.
3. Medication: If you have your diabetes medications with you, continue to take them as prescribed. If your blood glucose levels are significantly elevated, you may need to adjust your medication regimen, but this should only be done under medical guidance.
4. Seek Medical Attention: Given the complexity of managing diabetes in the context of a burn injury, it is imperative to seek medical attention as soon as possible. Burns can lead to complications that require professional medical treatment, and your hyperglycemia needs to be managed in the context of your burn injury.
5. Wound Care: Continue to care for your burn wound by keeping it clean and covered to prevent infection. Do not apply any creams or ointments unless directed by a healthcare professional.
6. Nutrition: Maintain a balanced diet that is consistent with your diabetic dietary recommendations. Avoid high-sugar foods that can exacerbate hyperglycemia.
7. Avoid Infection: Keep an eye out for signs of infection in your burn wound, such as increased redness, swelling, pain, or discharge. Infections can further increase your blood glucose levels and complicate your recovery.
8. Documentation: Keep a record of your blood glucose readings, medication doses, and any symptoms you are experiencing. This information will be valuable to healthcare providers when you receive medical care.

Remember, the management of burns in diabetic patients can be complex due to the interplay between the hypermetabolic response to burns and the dysregulation of glucose metabolism in diabetes. Clinical studies have shown that maintaining good glucose control after a burn injury can improve outcomes and reduce complications [34, 41].

Given the potential for serious complications and the need for specialized care, it is important to reach a medical facility where you can receive comprehensive treatment for both your burn and diabetes as soon as possible. If you are in a remote location, consider contacting emergency services or local authorities to arrange for transportation to the nearest medical center.

Sources:

1. Marc G. Jeschke Lars-Peter Kamolz Shahriar Shahrokhi - Burn Care and Treatment_ A Practical Guide-Springer 2021.pdf (page 85)
2. Marc G. Jeschke Lars-Peter Kamolz Shahriar Shahrokhi - Burn Care and Treatment_ A Practical Guide-Springer 2021.pdf (page 181)