Insulin sensitivity in septic cancer-bearing patients Journal Article


Authors: Sauerwein, H. P.; Pesola, G. R.; Godfried, M. H.; Levinson, M. R.; Jeevanandam, M.; Brennan, M. F.
Article Title: Insulin sensitivity in septic cancer-bearing patients
Abstract: Resistance to insulin's effect on glucose metabolism is a well-documented phenomenon. The magnitude of resistance to insulin's antilipolytic action is usually less than the resistance to insulin's action on glucose metabolism. In sepsis, resistance to the antilipolytic effect of insulin may be more prominent than resistance to insulin's action on glucose metabolism. Therefore, free fatty acid (FFA) turnover, FFA concentration, glucose tissue uptake, and endogenous glucose production were measured in nine septic cancer-bearing patients and six healthy volunteers during a constant glucose load at two different insulin concentrations. During infusion of glucose alone, plasma insulin concentration in patients and control subjects were, respectively 33 +/- 7 mU/L and 23 +/- 4 mU/L. When plasma glucose was clamped at the low normal range these values were, respectively, 85 +/- 17 mU/L and 28 +/- 5 mU/L (p < 0.05). Glucose tissue uptake and endogenous glucose production were not significantly different in patients and control subjects in both parts of the study. FFA turnover and FFA concentrations were significantly higher in the patients compared with the control subjects (p < 0.001) in both parts of the study. It is concluded that in septic cancer-bearing patients, resistance to insulin's effect on FFA turnover is more pronounced than resistance to its inhibiting effect on endogenous glucose production and its stimulating effect on glucose tissue uptake.
Keywords: kinetics; oxidation; injury; resistance; starvation; turnover; lipid-metabolism; dependent diabetes-mellitus; fatty-acid; glucose-infusion
Journal Title: Journal of Parenteral and Enteral Nutrition
Volume: 15
Issue: 6
ISSN: 0148-6071
Publisher: Sage Publications  
Date Published: 1991-11-01
Start Page: 653
End Page: 658
Language: English
ACCESSION: WOS:A1991GP14500012
DOI: 10.1177/0148607191015006653
PROVIDER: wos
PUBMED: 1766056
Notes: Source: Wos
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MSK Authors
  1. Murray F Brennan
    992 Brennan
  2. Gene R. Pesola
    16 Pesola