EFFECT OF MORPHINE AND IBUPROFEN ON ENDOGENOUS INSULIN LEVEL IN PATIENTS WITH CANCER PAIN: A CLINICAL STUDY
Preclinical study shows that endogenous insulin plays a critical role in the modulation of pain. To investigate this, we selected cancer pain as a model and studied the influence of morphine and ibuprofen on endogenous insulin and various biochemical parameters in patients with cancer pain. The clinical study was conducted in a total of 75 cancer patients out of which 25 patients were administered morphine 10mg for pain relief, another 25 were administered ibuprofen 400 mg and remaining 25 cancer patients without pain formed the control group. Pain was measured using visual analogue scale. Serum insulin, glucose, lipid profile, albumin and total protein levels were determined by standard methods in clinical laboratory. Serum insulin (p<0.0001), cholesterol (p<0.0004), triglyceride (p< 0.0003) and LDL cholesterol (p<0.001) are significantly higher compared to control. Although no significant differences in mean values of blood glucose in morphine and ibuprofen drug administered patients were observed, serum insulin values in these patients showed significant increase compared to control with no significant change in HDL, albumin and total protein level. The results of the study done in a small number of patient populations propose that endogenous insulin and lipid level may be playing a critical role as new markers in painful clinical conditions, however can be confirmed from the data of a larger sample size.