[Varying utilization of glucose and sorbitol in drug-induced hypercortical metabolism]

Utilisation of glucose and sorbitol in medically induced hypercorticalic states was investigated by means of the steroid-glucose-tolerance-test (SGTT) in 9 children, aged 6-16 years suffering from obesity and prediabetes. Prednisolone (1 mg/kg up to 20 mg) was applied 9 and 3 h prior to the loading tests. Blood samples were taken 0, 2, 5, 30, 60, 90, 120, 150 and 180 min after the onset of the loading tests. During the intravenous infusion of glucose (initial 0,33 g/kg followed by 12 mg/kg/min through 2 h) the mean blood glucose values increased from 103 +/- 15,5 to 388 +/- 96,6 mg/100 ml. Decrease of glycemia began delayed after 90 min, and did not approach the 180 min normal values in 3 of 9 patients. In analogous sorbitol-loading tests performed 2 to 6 days later blood glucose rose from 93 +/- 16,6 mg/100 ml to 129 +/- 28,7 mg/100 ml only. There was a significantly higher blood glucose level on SGTT as compared to steroid-sorbitol loading through the whole test period. Renal losses of glucose after SGTT as well as sorbitol losses after steroid-sorbitol loading amounted to approximately 14% of the doses supplied. The resulting data point to the advantages of combined glucose and non-glucose carbohydrate application for parenteral nutrition in medically induced and postoperative hypercorticalic states of metabolism.