Increased plasma glucose clearance in sepsis is due to increased exchange between plasma and interstitial fluid

It has long been unclear why plasma glucose clearance is increased during sepsis, an insulin-resistant state. To address this issue, we studied sheep given a constant infusion of endotoxin for at least 24 h (n = 5). We gave a bolus of 6,6 d2 glucose and determined the fractional exchange of glucose between plasma and interstitial fluid using compartmental modeling techniques. We found that exchange of glucose between plasma and interstitial fluid was significantly increased in sepsis, but the fractional clearance of glucose from interstitial fluid was not significantly altered. Thus the observed increased plasma glucose clearance was solely due to alterations in glucose exchange between plasma and interstitial fluid and was unrelated to glucose transport into cells.