Report of investigations to determine the therapeutic dose of dextrose (d-glucose) administered intravenously

Abstract

1.1. Dextrose solution administered by intravenous injection now plays an important rôle as a general therapeutic procedure.2.2. Despite the widespread use of this measure adequate observance has not been made of two important points, (1) the preferable concentration or percentage of dextrose solution to be used and (2) the proper rate of its injection.3.3. The actual therapeutic dose of dextrose which should be administered intravenously has not been known so that both underdosage and overdosage have been common faults.4.4. Individualization of cases must aid in deciding the concentration of solutions to be injected, but as an average 25 per cent dextrose solution seems to be the most desirable strength.5.5. It has been established by previous work that the proper rate of injection into an average sized adult should consume at least thirty to thirty-five minutes for every 25 gm. of dextrose.6.6. These present investigations apparently establish the therapeutic intravenous dose of dextrose at 75 gm. for an average sized adult. Less than this will not give the maximum therapeutic effect, and more than this is likely to produce a reaction from overstimulation of the insulin-producing activity of the patient's pancreas. Graphs of bloodsugar curves during dextrose injections show a beginning fall at about this amount thus indicating that the maximum safe limit has been reached.7.7. Single intravenous doses of dextrose repeated from one to three times daily as necessary are preferable to prolonged injections for this same reason of excessive endogenous insulin-production. It is likely that many “reactions” attributed to faulty dextrose administration have actually been hypoglycemic reactions from prolonged overdosage with dextrose resulting in overstimulation of the pancreas.8.8. By averaging in one's adult patients such variable factors as body weight, individual differences in pancreatic activity, variations in nourishment, and previous medication, it is possible to make a broad statement as to the average routine administration of dextrose. The most beneficial results seem to follow the intravenous administration to an adult of 75 gm, dextrose in a volume of 300 c.c. (25 per cent) during a period of ninety to one hundred minutes. It is suggested that the amount of dextrose thus administered to a half-grown child should be one-half, and to an infant one-quarter of the adult dose but that the same total length of time (ninety to one hundred minutes) should be consumed for these injections. Other concentrations of solution or lesser amounts may be used according to individual requirements but the above represent safe and adequate average standards of dextrose dosage.