In a group of 20 consecutive patients hospitalized with severe traumatic shock, mean plasma glucagon levels averaged 328±65 μμg/ml, significantly above the normal fasting levels. Insulin concentration was normal, and plasma glucose levels averaged 188(±14) mg/100 ml, significantly above normal. Insulin glucagon molar ratio was low in 17 of the 20 patients. In 3 patients undergoing major surgery without associated hypotension, glucagon concentrations did not rise comparably. Hyperglucagonemia without a proportional rise in insulin may be the usual islet cell response to severe trauma and possibly could contribute to survival.
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