Fuel utilization following injury: relationship to hormonal environment

To investigate the relationship between fuel metabolism, insulin resistance, and hormonal environment, insulin clamp studies and indirect calorimetry were performed in nine normal volunteers after they had received a continuous infusion of the three "stress" hormones, cortisol, glucagon, and epinephrine, for 3 days. Studies after a 3-day infusion of saline served as control. Diets were constant and matched on both occasions. Hormonal infusion achieved hormone concentrations similar to those seen following mild to moderate injury. In this altered environment, insulin failed to suppress endogenous glucose production and resulted in reduced glucose disposal. The glucose that was taken up was oxidized, not stored. Furthermore, insulin failed to suppress fat oxidation. The altered hormonal environment achieved by triple hormonal infusion, simulated many of the features of post-traumatic fuel metabolism.