Patients with sepsis, burn, or trauma commonly enter a hypermetabolic stress state that is
associated with a number of alterations in carbohydrate metabolism. These alterations
include enhanced peripheral glucose uptake and utilization, hyperlactatemia, increased
glucose production, depressed glycogenesis, glucose intolerance, and insulin resistance.
The hyper-metabolic state is induced by the area of infection or injury as well as by organs
involved in the immunologic response to stress; it generates a glycemic milieu that is …