Alterations in glucose kinetics following thermal injury

The volume of the body glucose space (liter/kg), the proportional rate of glucose disappearance (%/min), and the mass flow through the glucose space (mg/kg/min) were determined in 21 nondiabetic burned patients (mean burn size of 45% total body surface, burn range 13.5% to 75%) between the sixth and 90th postburn day and compared with similar measurements in 12 normal individuals of comparable age and body weight. Glucose flow is elevated in burned patients during the peak of the hypermetabolic response to thermal injury. The elevated blood glucose and glucose flow are the result of increased glucose production, not impaired glucose disappearance, and are associated in time with posttraumatic hyperglucagonemia, increased catecholamine elaboration, and normal fasting serum insulin.