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Mechanism and pharmacology Kruse et al

Disease states that affect intra-portal insulin levels by increasing insulin resistance causing compensatory intra-portal hyperinsulinemia or by decreasing pancreatic -cell insulin secretion causing intra-portal hypoinsulinemia results in changes to hepatic IGF-I synthesis and secretion, and consequently changes in GH levels via the negative feedback loop

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It is interesting to note both Cu chelators such as d-penicillamine and TTM and Cu-delivery agents such as Cu II (atsm) have shown beneficial effects in several mouse models

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Immediate treatment post-debridement was crucial for optimal results