Glucose and insulin homeostasis during postoperative carbohydrate infusions

Hypertonic fructose and sorbitol solutions are claimed to have advantages over glucose in nutritional regimen due to their rapid hepatic metabolism. Insulin is essential for the extrahepatic metabolism of all three carbohydrates. At therapeutic rates (0.5 g/kg body weight/h) in the postoperative period they produce hyperglycaemia and an insulin response, not previously evident and similar to that of glucose. These changes are probably related to their intracellular metabolism and may explain the similar nitrogen-sparing capabilities of each carbohydrate following operative trauma.