A common question is how much should we expect the blood glucose concentration to increase after dextrose 50% (D50) administration. Fortunately, there is an answer from 3 studies.
- Balentine JR, Gaeta TJ, Kessler D, Bagiella E, Lee T. Effect of 50 milliliters of 50% dextrose in water administration on the blood sugar of euglycemic volunteers. Acad Emerg Med. 1998;5(7):691-694. doi:10.1111/j.1553-2712.1998.tb02487.x PMID 9678393
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- Population: Healthy volunteers in the ED
- Intervention: 25 gm (1 ampule of D50)
- Result: Mean increase of 162 mg/dL at 5 min. Glucose concentrations returned to baseline by 30 minutes.
- Murthy MS, Duby JJ, Parker PL, Durbin-Johnson BP, Roach DM, Louie EL. Blood glucose response to rescue dextrose in hypoglycemic, critically ill patients receiving an insulin infusion. Ann Pharmacother. 2015;49(8):892-896. doi:10.1177/1060028015585574. PMID 25986006
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- Population: Critically ill patients experiencing hypoglycemia while on insulin infusions
- Intervention: D50
- Result: Median increase of 4 mg/dL per gm of D50 administered
- Adler PM. Serum glucose changes after administration of 50% dextrose solution: pre- and in-hospital calculations. Am J Emerg Med. 1986;4(6):504-506. doi:10.1016/S0735-6757(86)80004-3. PMID 3778594
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- Population: ED patients with altered mental status (23 with diabetes, 28 without diabetes)
- Intervention: 25 gm (50 mL of D50)
- Result: Mean increase of 166 mg/dL
Take Home Points
- Glucose concentrations increase 4-6 mg/dL per gm of dextrose administered
- 50 mL of D50 = 25 gm = expected 100-150 mg/dL glucose rise
- D50 rescue glucose is short-lived (30 minutes)
- If the blood glucose does not respond as anticipated, investigate further (e.g., IV decannulation)
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The post EM Pharm Pearls: Estimated rise in blood glucose concentration with dextrose administration appeared first on ALiEM.
