Alterations of the basal serum insulin and blood glucose in brain-injured patients.

Serial fasting blood glucose and basal serum insulin were measured in brain-injured patients. The endocrine changes were compared with the level of consciousness. Evaluating the serial examinations of 92 brain-injured and 31 control patients we came to the following conclusions. There is a quantitative correlation between the alterations in the level of consciousness and the fasting blood-glucose and serum-insulin levels in brain-injured patients. Deep coma is connected with a high blood-sugar level, clear consciousness with a normal glucose level. The insulin level is, however, decreased in the comatose state and normal in the state of clear consciousness. According to the alterations in blood-glucose and insulin levels, brain-injured patients can be divided into four groups. The alterations in the insulin level cannot give a proper explanation of the blood-sugar changes. Some changes in the levels of both blood glucose and serum insulin may have prognostic significance. According to our results it can be supposed that certain cerebral structures take part in the regulation of the basal insulin secretion.