Journal ArticleDOI
Nonsuppressability of gluconeogenesis by glucose in septic patients
TLDR
The data indicate that there is a twofold increase in the conversion of alanine into glucose in sepsis and, further, this increase was observed while the patients were receiving a constant glucose infusion prior to and during the single injection of (14C)L-alanine.Abstract:
The contribution of alanine to the synthesis of glucose and the oxidation of alanine was evaluated in normal and septic patients using ( 14 C)L-alanine. The data indicate that there is a twofold increase in the conversion of alanine into glucose in sepsis and, further, this increase was observed while the patients were receiving a constant glucose infusion (100 mg/min) prior to and during the single injection of ( 14 C)L-alanine. Failure of glucose to decrease this gluconeogenic response in these septic patients clearly indicates that the controlling mechanism for glucose synthesis is modified following injury and undoubtedly plays a role in the abnormal carbohydrate metabolism observed in injury. The contribution of alanine carbon to oxidation was the same in the control and septic group as measured by the per cent of the ( 14 C)L-alanine dose expired in 3 h. Since the control subjects received glucose continuously during the study with and without amino acids, it is clear that nutritional intake and injury has minimal effect on the oxidation of alanine. This suggests that transamination is not affected by sepsis nor is there an inhibition of pyruvate oxidation following sepsis.read more
Citations
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Journal ArticleDOI
Sepsis and septic shock—A review of laboratory models and a proposal
TL;DR: Previously used models of sepsis such as the administration of endotoxin, intravenous infusion of live organisms, theadministration of fecal material into the peritoneal cavity, the placement of infected foreignMaterial into the soft tissues of the extremity, and surgical operations that partially destroy the normal barriers of the gastrointestinal tract are reviewed.
Journal ArticleDOI
Infection and diabetes: The case for glucose control
TL;DR: Good control of blood sugar in diabetic patients is a desirable goal in the prevention of certain infections (Candida vaginitis, for example) and to ensure maintenance of normal host defense mechanisms that determine resistance and response to infection.
Journal ArticleDOI
A.S.P.E.N. Clinical Guidelines: Nutrition Support of the Critically Ill Child
Nilesh M. Mehta,Charlene Compher +1 more
TL;DR: The use of specific nutrients, which possess a drug-like effect on the immune or inflammatory state during critical illness, continues to be an exciting area of investigation and there is an urgent need to conduct well-designed, multicenter trials in this area of clinical practice.
Journal ArticleDOI
Septic autocannibalism. A failure of exogenous nutritional support.
TL;DR: Evidence is presented which suggests that fatal sepsis is associated with an increased release of endogenous valine and isoleucine into plasma, as well as increased plasma levels of tyrosine, proline, and methionine, which is consistent with the hypothesis that increased muscle protein catabolism is occurring with a differential utilization of branch chain amino acids.
Journal ArticleDOI
Effect of injury and infection on visceral metabolism and circulation.
Douglas W. Wilmore,Cleon W. Goodwin,Louis H. Aulick,Michael C. Powanda,Arthur D. Mason,Basil A. Pruitt +5 more
TL;DR: The changes in hepatic glucose output in bacteremic patients occurred without significant differences in EHBF, oxygen utilization, or lactate uptake, but were associated with marked alterations in amino acid uptake.
References
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Journal ArticleDOI
The glucose-alanine cycle.
TL;DR: A glucose-alanine cycle in which alanine is formed peripherally by transamination of glucose-derived pyruvate and transported to the liver where its carbon skeleton is reconverted to glucose is suggested.
Journal ArticleDOI
Glucose metabolism during leg exercise in man
J. Wahren,J. Wahren,Philip Felig,Philip Felig,Gunvor Ahlborg,Gunvor Ahlborg,Lennart Jorfeldt,Lennart Jorfeldt +7 more
TL;DR: It is concluded that blood glucose becomes an increasingly important substrate for muscle oxidation during prolonged exercise of this type and peripheral glucose utilization increases in exercise despite a reduction in circulating insulin levels.
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Amino acid metabolism in exercising man
Philip Felig,John Wahren +1 more
TL;DR: The data suggest that synthesis of alanine in muscle, presumably by transamination of glucose-derived pyruvate, is increased in exercise probably as a consequence of increased availability of pyruVate and amino groups; circulating alanines serves an important carrier function in the transport of amino groups from peripheral muscle to the liver, particularly during exercise.
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A Receptor Mechanism for the Inhibition Of Insulin Release by Epinephrine in Man
TL;DR: It is concluded that the lipolytic effect of epinephrine is unrelated to its effects on IRI release and appears to conflict with the Randle hypothesis and raise some doubt as to whether plasma FFA concentrations are direct determinants of glucose or IRI concentrations in normal man.
Journal ArticleDOI
Control of Gluconeogenesis from Amino Acids in the Perfused Rat Liver
TL;DR: It is proposed that glucagon and possibly catecholamines play a role in the physiological regulation of gluconeogenesis from amino acids by increasing the formation of cyclic 3',5'AMP, which acts to stimulate both the transport of amino acids into the hepatic cell and the conversion of pyruvate to P-pyruvates.