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Updated: Mar 13, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Influence of Glycemic Control on Endogenous Circulating Ketone Concentrations in Adults Following Traumatic Brain
Stephanie M Wolahan1, Mayumi L Prins2, David L McArthur2
1Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, University of California - Los Angeles, Los Angeles, CA, USA. swolahan@mednet.ucla.edu.
Background:
The objective was to investigate the impact of targeting tight glycemic control (4.4-6.1 mM) on endogenous ketogenesis in severely head-injured adults.
Methods:
The data were prospectively collected during a randomized, within-patient crossover study comparing tight to loose glycemic control, defined as 6.7-8.3 mM. Blood was collected periodically during both tight and loose glycemic control epochs. Post hoc analysis of insulin dose and total nutritional provision was performed.
Results:
Fifteen patients completed the crossover study. Total ketones were increased 81 μM ([38 135], p < 0.001) when blood glucose was targeted to tight (4.4-6.1 mM) compared with loose glycemic control (6.7-8.3 mM), corresponding to a 60 % increase. There was a significant decrease in total nutritional provisions (p = 0.006) and a significant increase in insulin dose (p = 0.008).
Conclusions:
Permissive underfeeding was tolerated when targeting tight glycemic control, but total nutritional support is an important factor when treating hyperglycemia.
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