Hyperglycemia may suggest the presence of sepsis in diabetic patients. Proposed pathogeneses include increased amounts of catecholamines, increased cortisol and glucagon in the circulation, peripheral insulin resistance, impaired glucose utilization, and decreased insulin secretion. Hypoglycemia with glucose levels as low as 10 to 20 mg/dL has been reported but is a relatively uncommon manifestation of sepsis. Bacterial infections associated with hypoglycemia include S. aureus, S. pyogenes, S. pneumoniae, Listeria monocytogenes, Haemophilus influenzae, Neisseria meningitidis, and Enterobacteriaceae. The proposed pathogenesis of hypoglycemia includes the depletion of hepatitic glycogen and inhibition of gluconeogeneses.
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