Gluconeogenic Response During Glucose Infusions in Patients Following Skeletal Trauma or During Sepsis

Abstract

In order to quantitate the effect of sepsis and skeletal trauma on gluconeogenesis, four septic and five skeletal trauma patients were evaluated for their ability to convert ¹⁴ C-L-alanine to ¹⁴ C-glucose while receiving 5% dextrose by peripheral vein. In the septic group, the mean glucose pool size increased by 35% and the glucose turnover rate increased by 85% over normal. The alanine conversion averaged 11.1% of the dose. The skeletal trauma group showed a glucose pool size increase of 61%, a 100% increase in glucose turnover rate and a 11.7% conversion of the alanine dose to glucose. The increased conversion of ¹⁴ C-alanine to ¹⁴ C-glucose in both sepsis and skeletal trauma in the face of an exogenous glucose infusion indicates an abnormal unsuppressible response. Each of the above parameters when compared to normal values was found to be significant at levels greater than 97.5%. The percentages of the dose expired as ¹⁴ CO₂ in three hours were not significantly different from the normals.