Acute pancreatitis has been reported in several studies to increase the catabolism and proteolysis of skeletal muscle in comparison with normal controls. Decreased levels of total plasma proteins and rapid turnover proteins and a marked decrease of the ratio of branched-chain to aromatic amino acid further characterize the hypercatabolic state. Significant decreases in plasma essential amino acids, with marked reductions of almost all amino acids in the liver and increased uptake of endogenous amino acids by the skeletal muscle mass, have been reported clinically and experimentally. Gluconeogenesis increases, and glucose clearance and oxidation diminish, leading to glucose intolerance in 40% to 90% of cases. As a consequence, insulin canbe required in as many as 81% of patients.