What fluid is used to increase blood sugar?

Fluids for Increasing Blood Sugar

Pure glucose (dextrose) is the most effective fluid for increasing blood sugar, with 15-20g of oral glucose or intravenous dextrose solutions (D10 or D50) being the preferred treatments for hypoglycemia. 1

Oral Options for Increasing Blood Sugar

When treating hypoglycemia or needing to increase blood glucose levels, the following options are available:

• Pure glucose: Most effective option, raising blood glucose by approximately 40 mg/dL over 30 minutes with 10g of glucose, and 60 mg/dL over 45 minutes with 20g 1
• Any carbohydrate containing glucose: While pure glucose is preferred, any form of carbohydrate containing glucose will effectively raise blood sugar 1
• Fruit juice or regular soda: Contains glucose and can be used as alternatives 2

Intravenous Options for Increasing Blood Sugar

For medical settings where intravenous administration is needed:

• Dextrose 50% (D50): Traditional treatment, given as 10 mL (5g) aliquots intravenously 3

  • Rapidly increases blood glucose but may cause rebound hyperglycemia
  • Studies show it raises blood glucose to higher levels (median 9.4 mmol/L) compared to D10 4

• Dextrose 10% (D10): Increasingly recommended alternative 4, 5, 6

  • Given as 50 mL (5g) aliquots intravenously
  • Results in more controlled glucose elevation (median 6.2 mmol/L) 4
  • Requires smaller total doses to achieve normoglycemia 4

• Dextrose 5% in normal saline (D5NS): Can be used for maintenance of blood glucose 1

  • Particularly useful in diabetic ketoacidosis management once glucose falls below 250 mg/dL 1

Dosing Recommendations

For Oral Administration:

• Initial dose: 15-20g of glucose 1, 2
• Recheck blood glucose after 15 minutes
• Repeat dose if hypoglycemia persists

For Intravenous Administration:

• D50: 10 mL (5g) IV push, may repeat as needed 3
• D10: 50 mL (5g) IV, may repeat as needed 4, 5
• For pediatric patients: Lower concentrations and doses based on weight 1

Important Clinical Considerations

1. Monitoring after treatment: Blood glucose should be rechecked 15 minutes after initial treatment and again at 60 minutes as additional treatment may be necessary 1

2. Prevention of recurrent hypoglycemia: After initial treatment, patients should consume a meal or snack containing carbohydrates to prevent recurrence 2

3. Avoid hyperglycemia: D10 may be preferable to D50 in many situations as it results in more physiologic glucose levels and reduces the risk of rebound hyperglycemia 4, 6, 7

4. Acute illness management: During acute illness in patients with diabetes, ingestion of 150-200g carbohydrate daily (45-50g every 3-4 hours) is recommended to maintain blood glucose and prevent ketosis 1

5. Non-diabetic patients: Research shows that non-diabetic patients rarely develop hypoglycemia even after prolonged fasting (13+ hours), suggesting routine use of dextrose-containing fluids is not necessary for prevention 8

Pitfalls to Avoid

• Adding protein to carbohydrate treatment does not affect glycemic response or prevent subsequent hypoglycemia 1

• Adding fat may delay the acute glycemic response and should be avoided when rapid glucose elevation is needed 1

• Using hypotonic solutions (like D5W alone) in patients with acute ischemic stroke may exacerbate brain edema 1

• Contamination of arterial line samples with glucose-containing fluids can lead to falsely elevated glucose readings and inappropriate insulin administration 1

• Overtreatment with D50 can cause significant hyperglycemia, with studies showing glucose levels exceeding 10 mmol/L in 72% of non-diabetic patients receiving just 500 mL of dextrose-containing fluids 8