During illness and trauma hepatic glucose production may exceed how many grams per day?

• A. 200 g/day
• B. 500 g/day
• C. 800 g/day
• D. 1000 g/day

Answer: (B)

In a stress state from illness or trauma, the body shifts to boost hepatic glucose production to supply energy to the brain, immune cells, and other tissues. This ramp-up is driven by a surge of stress hormones (glucagon, cortisol, and catecholamines) and increased substrate availability. The liver starts pulling more substrates from the body—amino acids from muscle breakdown, glycerol from fat, and lactate—so gluconeogenesis and glycogenolysis work overtime to push glucose into the bloodstream.

Because of this heightened response, hepatic glucose production often rises to about 500 grams per day. That level represents the substantial increase over the fasting baseline and is a commonly cited figure in the context of illness and trauma. While extreme cases can push production higher (into the hundreds more grams per day), the practical takeaway is that the stress response commonly drives glucose output up to around 500 g/day to meet the increased metabolic demands. This understanding helps explain why energy and protein needs rise so markedly in critically ill patients and why nutrition plans must account for elevated glucose production.