Chronic tissue insulin resistance following hemorrhagic shock.

Metabolism of fat and muscle tissue was measured for 30 days following shock and reinfusion in rabbits. Tissue insulin resistance in the post-shock period was demonstrated by decreased oxidation of glucose and decreased incorporation of glucose into neutral lipid or glycogen during incubation with insulin. In addition, the insulin stimulated incorporation of amino acids into muscle protein was markedly reduced after shock. Conversely, the capacity of muscle to oxidize leucine was enhanced by shock, even in the presence of insulin. Tissue insulin resistance and increased leucine catabolism are likely to contribute to the general metabolic response to shock and trauma.