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Glucose and FFA kinetics in sepsis: role of glucagon and sympathetic nervous system activity.

We have assessed the role of glucagon and sympathetic nervous system (SNS) activity on glucose and palmitate kinetics and oxidation in the conscious dog infused with live Escherichia coli bacteria by means of the simultaneous primed constant infusion of [1,2-13C]palmitate and [U-14C]-glucose. The basal rate of glucose production in septic dogs and controls was similar. However, when the glucagon concentration was selectively decreased in the septic animals by the appropriate infusion of somatostatin (S), insulin (I), and glucagon (G), the rate of glucose production decreased significantly, whereas in control animals S + I + G infusion had no effect on glucose kinetics. When alpha- and beta-adrenergic blockade was added to the infusion, the rate of glucose production decreased further and hypoglycemia developed in the septic dogs, whereas in the controls both glucose production and concentration increased. The basal rate of appearance of palmitate was increased in the septic dogs (P less than 0.01). S + I + G had no effect on palmitate appearance in either group, and sympathetic blockade caused a significant decrease in palmitate appearance in both groups of dogs. The rates of oxidation of both glucose and palmitate was related directly to their availability in plasma. Thus, in sepsis, glucagon and SNS activity play important roles in the mobilization of glucose and palmitate into the plasma and therefore in the overall state of energy metabolism.