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December 1980

Sepsis, Glucose Intolerance, and Protein MalnutritionA Metabolic Paradox

Author Affiliations

From the Department of Surgery, Wayne State University School of Medicine, Detroit, and the Surgical Nutrition and Metabolism Unit, Harper-Grace Hospital, Detroit (Dr Kirkpatrick).

Arch Surg. 1980;115(12):1415-1418. doi:10.1001/archsurg.1980.01380120003001

• Glucose intolerance and its hormonal influence was examined in patients with sepsis. Eighteen patients were included in the protocol, which studied the response to a standard intravenous glucose tolerance test (GTT) in the postoperative stressed, septic, and septic protein malnourished (depressed albumin level) states. Four groups could be defined: stress (1), sepsis with depressed albumin level and normal glucose tolerance (2), sepsis with mild glucose intolerance and normal albumin levels (3), and sepsis with severe glucose intolerance and depressed albumin (4). Serial hormone levels were measured during the GTT, including insulin, glucagon, epinephrine, and human growth hormone values. Each group demonstrated a characteristic hormone profile. In a comparison with controls, group 2 was associated with mild suppression of insulin; group 3 exhibited mild glucose intolerance, hyperglucagonemia, and increased insulin; and group 4 demonstrated severe glucose intolerance, hyperglucagonemia, and marked suppression of growth hormone production.

(Arch Surg 115:1415-1418, 1980)

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