Under sepsis and stress, which metabolic alterations are most likely to occur?

• A. increased glucose production and decreased glucose uptake
• B. increased glucose production and increased glucose uptake
• C. decreased glucose production and decreased glucose uptake
• D. decreased glucose production and increased glucose uptake

Answer: (A)

In sepsis and stress, the body shifts to a hypermetabolic state driven by counterregulatory hormones such as glucagon, cortisol, and catecholamines. These hormones promote hepatic glucose production through glycogenolysis and gluconeogenesis. At the same time, peripheral tissues become less responsive to insulin, so glucose uptake by muscle and adipose tissue decreases. The net effect is more glucose produced and less glucose cleared by tissues, matching increased glucose production with decreased glucose uptake. This pattern fits the septic stress response, whereas other patterns would imply less production or more uptake, which isn’t characteristic of this state.