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Effect of 50 Milliliters of 50% Dextrose in Water Administration on the Blood Sugar of Euglycemic Volunteers
Author(s) -
Balentine Jerry R.,
Gaeta Theodore J.,
Kessler Diana,
Bagiella Emilia,
Lee Teddy
Publication year - 1998
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.1998.tb02487.x
Subject(s) - medicine , bolus (digestion) , blood sugar , prospective cohort study , anesthesia , endocrinology , zoology , diabetes mellitus , biology
.Objective : To evaluate the effect of administration of 1 ampule of 50% dextrose in water solution (D 50 W) on serum glucose levels in healthy adult volunteers, the authors set out to determine whether a pre‐D 60 W serum glucose level can be predicted from the ED sample. Methods : This was a prospective, interventional study conducted from the ED of an urban, university‐affiliated hospital. All subjects were healthy employee volunteers between 25 and 40 years of age. Baseline serum glucose levels were determined and all subjects were given an IV bolus of 25 grams of 50% dextrose solution. The main outcome measures were post‐D 50 W serum glucose levels (observed) at 5 predetermined time intervals (5 min, 15 min, 30 min, 1 hr, and 2 hr). An expected change in serum glucose was calculated using the volume of distribution formula for glucose. Results : Twenty‐five volunteers (17 males and 8 females) participated in the study. The mean baseline serum glucose was 82.3 ± 13.5 mg/dL. The mean post‐infusion levels were: 244.4 ± 44.6 mg/dL (5 min), 145.8 ± 52.3 mg/dL (15 min), 88.1 ± 28.8 mg/dL (30 min), 77.6 ± 13.6 mg/dL (60 min), and 83.2 ± 11.4 mg/dL (120 min). Using a mixed‐effect regression model, statistically significant increases in serum glucose levels were found at 5 minutes (p < 0.001) and 15 minutes (p < 00001) following administration of D 50 W. There was a return to baseline serum glucose by 30 minutes. The expected change based on the volume of distribution formula (53.7 ± 34.9) did not correlate with the observed changes at any measured time interval. Conclusion : Without pre‐intervention blood drawing by emergency medical services, it is not possible to accurately predict pre‐D 50 W serum glucose levels based on post‐D 50 W glucose levels. The diagnosis of hypoglycemia as the etiology of altered mental status must therefore remain a diagnosis of exclusion. In addition, the return of serum glucose to baseline after 30 minutes suggests the duration of the effect of 1 ampule of D 50 W. Frequent re‐evaluation of the serum glucose levels of suspected or proven hypoglycemic patients after administration of D 50 W should be considered.