DETERMINATIONS OF GLUCOSE TURNOVER AND OXIDATION IN NORMAL VOLUNTEERS AND SEPTIC PATIENTS USING STABLE AND RADIO‐ISOTOPES

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Abstract
Rates of glucose turnover and oxidation were isotopically determined in normal volunteers (n= 16) and in severely septic patients (n= 10). Glucose turnover was determined using primed constant infusions of either 6-3H- or 6,6-d-glucose and glucose oxidation with either U-14C-glucose or U-13C-glucose after appropriate priming of the bicarbonate pool. Basal rates of glucose turnover, oxidation, and plasma clearance were significantly higher in the septic patients than in the volunteers. During glucose infusion (4 mg/kg·min) endogenous glucose production was virtually abolished in the volunteers (94±4% suppression). There was significantly less suppression in the septic patients (39±7%); (p<0.01). In addition, the percentage of available glucose oxidized (i.e. the percentage of glucose uptake oxidized) was significantly less in the septic patients. When the patients were studied during total parenteral nutrition (at a similar rate of glucose infusion) there was no further suppression of endogenous glucose production compared with that seen during 2h of glucose infusioin. However, the percentage of available glucose oxidized increased significantly. From these studies it is concluded that (i) septic patients continue to have ongoing consumption of host tissue despite receiving either glucose infusion or total parenteral nutrition, and (ii) septic patients are less able to oxidize glucose than normal volunteers when infused for only 2 h. However, adaptation occurs with the longer infusion time used in total parenteral nutrition (TPN).