J.Jpn. Surg. Soc.. 85(9): 995-1000, 1984
Report on the annual meeting
MANAGEMENT OF TOTAL PARENTERAL NUTRITION RELATED TO INSULIN CONTROL AND/OR NEW RECIPE IN DEPRESSED GLUCOSE METABOLISM
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First Departement of Surgery, Kobe University, School of Medicine Harumasa Ohyanagi, Seishi Nakaya, Etsuro Matsui, Seiya Suenaga, Hiroshi Kasahara, Masao Nishimoto, Yoichi Saitoh |
Fifty TPN cases out of 837 for 9 years were successfully performed insulin control, while 17 patients were unable to get sufficient calory in spite of insulin administration.
Cumulative expired CO2 after injection of radioactive carbohydrate in rats showed that each carbohydrate was utilized in the order of glucose, fructose, maltose, sorbitol and xylitol even in depressed glucose metabolism and that depressed carbohydrate metabolism was improved by adequate insulin injection.
Combined use of glucose, fructose and xylitol at 4 : 2 : 1 (GFX) was was experimentally revealed to be superior to glucose alone as carbohydrate source of TPN in depressed glucose metabolism. Compared with conventional TPN (C-TPN), GFX-TPN showed lower blood glucose and insulin level in rabbits of sepsis and rats of streptozotocin diabetes.
Contents of fructose 2,6 bisphosphate and triglyceride and activities of fructose 6 phoshate 2 kinase,acetyl CoA carboxylase and fatty acid synthetase in liver of these animals supported that GFX had favourable effects on glucose and fat utilization in depressed glucose metabolism.
Blood glucose of early postoperative patients was lower in GFX-TPN than in C-TPN.
key words: depressed glucose metabolism, TPN, GFX solution.
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