EFFECT OF 50 MILLILITERS OF 50-PERCENT DEXTROSE IN WATER ADMINISTRATION ON THE BLOOD-SUGAR OF EUGLYCEMIC VOLUNTEERS

Objective: To evaluate the effect of administration of 1 ampule of 50% dextrose in water solution (D50W) on serum glucose levels in healthy adult volunteers, the authors set out to determine whether a pre-D50W serum glucose level can be predicted from the ED sample. Methods: This was a prospective, interventional study conducted from the ED of an u rban, university-affiliated hospital. All subjects were healthy employ ee volunteers between 25 and 40 years of age. Baseline serum glucose l evels were determined and all subjects were given an IV bolus of 25 gr ams of 50% dextrose solution. The main outcome measures were post-D50W 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 gluc ose was calculated using the volume of distribution formula for glucos e. Results: Twenty-five volunteers (17 males and 8 females) participat ed 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 D50W. There was a return to baseli ne serum glucose by 30 minutes. The expected change based on the volum e of distribution formula (53.7 +/- 34.9) did not correlate with the o bserved changes at any measured time interval. Conclusion: Without pre -intervention blood drawing by emergency medical services, it is not p ossible to accurately predict pre-D50W serum glucose levels based on p ost-D50W glucose levels. The diagnosis of hypoglycemia as the etiology of altered mental status must therefore remain a diagnosis of exclusi on. In addition, the return of serum glucose to baseline after 30 minu tes suggests the duration of the effect of 1 ampule of D50W. Frequent re-evaluation of the serum glucose levels of suspected or proven hypog lycemic patients after administration of D50W should be considered.