Alterations in glucose metabolism in non-endocrine disease: potential implication for wasting

Diseases like sepsis, AIDS and cancer can induce an increase in endogenous glucose production. Sepsis and cancer induce insulin resistance whereas increased insulin sensitivity is found in AIDS. Non-oxidative glucose disposal is increased in sepsis and cancer but normal in AIDS. These differences in glucose metabolism between these three diseases characterized by wasting preclude energy-requiring changes in glucose metabolism as the common denominator for wasting in all three diseases. Moreover, the energy requirements of the changes in glucose metabolism induced by cancer and sepsis are rather small. Consequently, alterations in glucose metabolism are pathophysiological epiphenomena rather than a cause of wasting in disorders like sepsis, cancer and AIDS.