Iron Sucrose Does Not Affect Blood Sugar Levels
Iron sucrose is an intravenous iron preparation used to treat iron deficiency anemia and does not contain metabolically active sucrose that affects blood glucose—the "sucrose" in its name refers only to the stabilizing shell around the iron core, not dietary sugar. This is a critical distinction that often causes confusion among patients and clinicians.
Key Distinction: Iron Sucrose vs. Dietary Sucrose
The provided evidence addresses dietary sucrose (table sugar) and its effects on glucose metabolism in diabetic patients, but this is fundamentally different from iron sucrose as a medication:
- Dietary sucrose is a disaccharide (glucose + fructose) that is absorbed and metabolized, affecting blood glucose levels 1
- Iron sucrose is an intravenous iron complex where sucrose serves only as a stabilizing matrix for iron delivery—it is not metabolized as a carbohydrate 1
Clinical Evidence on Iron Sucrose Safety
The pediatric parenteral nutrition guidelines specifically address iron sucrose safety without any mention of glycemic effects:
- Iron sucrose is the most studied intravenous iron preparation in children with rare severe adverse events 1
- In studies involving 232 children receiving 1,624 doses of iron sucrose, no anaphylactic reactions occurred and only one adverse event (skin rash) was reported 1
- The documented adverse effects relate to allergic/anaphylactoid reactions (dyspnea, wheezing, hypotension, nausea), not glycemic disturbances 1
Iron Deficiency and Glucose Metabolism
Importantly, the relationship between iron and glucose works in the opposite direction—iron deficiency itself can impair glucose homeostasis:
- Iron deficiency anemia can negatively affect glycemic control and predispose diabetic patients to more complications 2
- Treatment of iron deficiency anemia in patients with type 2 diabetes significantly reduces fasting blood glucose (from 198.53 to 170.93 mg/dL, p<0.0001) and HbA1c (from 8.49% to 7.96%, p<0.0001) 3
- Iron depletion has been shown to be beneficial for insulin secretion and insulin action 4
Clinical Bottom Line
When administering iron sucrose to patients with diabetes or concerns about blood sugar, you can reassure them that the medication will not raise their blood glucose. In fact, correcting their iron deficiency may actually improve their glycemic control 3. The sucrose component in iron sucrose is not bioavailable as a carbohydrate and serves only as a pharmaceutical excipient for iron delivery 1.
Monitor patients receiving iron sucrose for the typical adverse effects (allergic reactions, hypotension) rather than glycemic changes 1.