Early Initiation of Low-Level Parenteral Dextrose Induces an Accelerated Diabetic Phenotype in Septic C57BL/6J Mice

Development of hyperglycemia during sepsis is associated with increased morbidity and mortality. Nutritional support is common practice in the intensive care unit, but the metabolic effects are not well understood. The purpose of this study is to determine the effect of early low level calorie provision on the development of hyperglycemia in a clinically relevant murine model of sepsis. C57BL/6J mice un-derwent femoral arterial and venous catheterization followed by cecal ligation and puncture (CLP) or sham surgery and low-dose intravenous dextrose or saline infusion. Blood glucose (BG), plasma insulin, and cytokines were measured after 24 hours. Additional septic mice underwent hyperinsulinemic euglycemic clamps or received intravenous insulin concurrent with dextrose to determine whole body insulin sensitivity and test the efficacy of insulin to reverse hyperglycemia. Neither dextrose infusion nor CLP alone induced hyperglycemia. Early initiation of low level dextrose in septic mice produced a variable glycemic response; 49% maintained euglycemia (BGThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author