HYPERGLUCAGONÆMIA AFTER BURNS

Abstract In eleven male patients with flame injury (all believed to be non-diabetic before injury) initial glucagon levels were increased despite administration of intravenous glucose. Values ranged from 185 to 662 pg. per ml. and averaged 327±42 pg. per ml. (mean±S.E.M.). They were significantly higher than the mean fasting levels in normal subjects (75 ±4 pg. per ml.). Insulin levels varied widely, but tended to be low in relation to the simultaneously measured blood-glucose level, which ranged from 95 to 205 mg. per 100 ml. In six patients the insulin/glucagon ratio was below 2'— i.e., the range observed in other catabolic states— despite the glucose infusion, while in ten patients it was below the levels normally attained during glucose administration. Among the survivors wound closure and weight stabilisation coincided with a rise in the insulin/glucagon ratio to or above normal. The findings suggest that the islets of Langerhans participate in the metabolic response to burns.

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