Glucose kinetics and responsiveness to insulin in the rat injured by burn.

The are persistent alterations in glucose metabolism in the rat during the first week after a 20 per cent body surface area burn injury. The basal rate of endogenous glucose production is elevated, and it is not suppressed to a normal degree by an exogenous glucose infusion. The hormonre data suggest that increased glucagon levels are responsible for the elevated rate of gluconeogenesis both before and during an exogenous glucose infusion. Basal glucose uptake was also elevated after injury, and there was a normal increment in the glucose metabolic clearance rate during an exogenous glucose infusion. The increase in the glucose metabolic clearance rate relative to the increase in the insulin concentration was equivalent in the burn and control groups of rats. This indicated a normal responsiveness to insulin after injury. Because there was no impairment in the capacity to take up an exogenous glucose infusion, we would question the insulin resistance rationale for administering insulin to patients rendered hyperglycemic by glucose infusion.