Enteral nutrition (carbohydrate source)
Glucose (dextrose) is the sugar that provides energy to the body and is the main energy source for the brain. In hospital it is given intravenously to treat very low blood sugar (hypoglycaemia) and as part of infusion fluids for hydration and nutrition.
Also known as: dextrose, Glicose, glucose, Glucose 5%
Corticosteroid + glucose: additive hyperglycaemia in patients on nutrition.
Systemic corticosteroids (dexamethasone) raise blood glucose by stimulating hepatic gluconeogenesis, reducing peripheral glucose uptake and increasing insulin resistance. In patients receiving glucose infusion (parenteral nutrition or hydration), the hyperglycaemic effect adds to the glucose load, potentially causing significant hyperglycaemia, especially in diabetics, but also in patients without known diabetes on high corticosteroid doses. Monitor capillary glucose (and diuresis), give insulin as needed and adjust the glucose load in nutrition when possible.
Corticosteroid + glucose: additive hyperglycaemia in patients on nutrition. Monitor blood glucose.
Corticosteroids raise glycaemia; glucose infusion adds a carbohydrate load.
Capillary/serum glucose.
Symptomatic hyperglycaemia, metabolic decompensation.
Monitor blood glucose and adjust insulin/antidiabetics during therapy.
DailyMed (FDA) — approved Dexamethasone label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7cbd9005-7df2-47ee-adb3-7244c1c69bc3 ; approved Glucose (dextrose) label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=36e9478c-5df0-4b47-b97d-de3626d7cb29 — additional reference: Prontuário Terapêutico do INFARMED (11th ed., 2012)
Dietary carbohydrate load adds to administered glucose.
Spread carbohydrate intake throughout the day.
EMC-UK (MHRA) — approved Glucose (dextrose) SmPC: https://www.medicines.org.uk/emc/product/13132/smpc
Alcohol may cause hypoglycaemia and disturb glycaemic control during nutrition.
Avoid alcohol during enteral/parenteral nutrition.
EMC-UK (MHRA) — approved Glucose (dextrose) SmPC: https://www.medicines.org.uk/emc/product/13132/smpc
Glucose administration raises glycaemia, requiring adjustment of antidiabetic therapy.
Monitor glucose and adjust insulin/antidiabetics during nutrition.
EMC-UK (MHRA) — approved Glucose (dextrose) SmPC: https://www.medicines.org.uk/emc/product/13132/smpc
Glucose is an essential nutrient; glucose solutions are used in pregnancy with glycaemic monitoring.
Monitor blood glucose, especially in gestational diabetes.
Compatible with breastfeeding.
No specific additional contraception.
EMC-UK (MHRA) — approved Glucose (dextrose) SmPC: https://www.medicines.org.uk/emc/product/13132/smpc
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Restores blood glucose and provides carbohydrate calories (approximately 3.4 kcal/g). The exposure-response relationship and time course of the pharmacodynamic response are not fully characterised.
Glucose is the main cellular energy substrate; its entry into cells is mediated by insulin (GLUT transporters). In the brain, glucose is virtually the only fuel, which explains the need to correct hypoglycaemia quickly.
Administration is exclusively intravenous; complete bioavailability by definition of the route. Distribution is rapid in the extracellular space, with insulin-dependent cellular uptake.
Administered glucose is oxidised to carbon dioxide and water (via glycolysis, Krebs cycle and oxidative phosphorylation) or stored as hepatic and muscle glycogen; excess can be converted to fat (lipogenesis).
Classical half-life does not apply (endogenous substrate); blood glucose is regulated by hormonal mechanisms (insulin, glucagon) with response within minutes. In diabetic patients persistent hyperglycaemia may occur.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
