Insulin Response to Glucose in Hypermetabolic Burn Patients.

摘要

Fifty-four intravenous glucose tolerance tests were performed in 12 normal individuals and 21 thermally injured patients. In the 17 hypermetabolic burn patients studied between the 6th and 16th days postinjury, fasting blood glucose was elevated but the instantaneous proportionality constant for glucose disappearance(k)was similar to that obtained in normal individuals. In the 5 convalescent patients studied between the 37th and 90th days postinjury, glucose and insulin dynamics appeared similar to those observed in starved man. In these burn patients, hypermetabolism and negative nitrogen balance occurred in association with a normal insulin response to glucose. Increased hepatic gluconegenesis appears to be characteristic of the catabolic response to this stress, directed by increased glucagon and catecholamines, not a decrease in fasting insulin or dampened insulin response.