Dextrose 10% or 50% in the treatment of hypoglycaemia out of hospital? A randomised controlled trial

Objective: To investigate whether 10% dextrose given in 5 g (50 ml) aliquots is more effective than 50% dextrose given in 5 g (10 ml) aliquots in the treatment of out of hospital hypoglycaemia. Design: Randomised controlled trial. Setting: Out of hospital patients attended by paramedics from a large...

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Bibliographic Details
Published in:Emergency medicine journal : EMJ 2005-07, Vol.22 (7), p.512-515
Main Authors: Moore, C, Woollard, M
Format: Article
Language:English
Subjects:
10% dextrose
50% dextrose
Adult
Aged
Aged, 80 and over
Blood Glucose - metabolism
Confidence intervals
Consciousness
Drug Administration Schedule
Emergencies
Emergency Service, Hospital
Female
Glasgow Coma Scale
Glucose
Glucose - administration & dosage
Glucose - chemistry
Humans
hypoglycaemia
Hypoglycemia - blood
Hypoglycemia - drug therapy
Male
Middle Aged
Mortality
out-of-hospital
paramedic
Paramedics
Prehospital Care
Researchers
Studies
Treatment Outcome
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Summary:Objective: To investigate whether 10% dextrose given in 5 g (50 ml) aliquots is more effective than 50% dextrose given in 5 g (10 ml) aliquots in the treatment of out of hospital hypoglycaemia. Design: Randomised controlled trial. Setting: Out of hospital patients attended by paramedics from a large UK ambulance service. Participants: 51 unresponsive adult patients with blood glucose levels ⩽4 mmol/l. Intervention: 5 g (50 ml) intravenous aliquots of 10% dextrose or 5 g (10 ml) intravenous aliquots of 50% dextrose to a maximum dose of 25 g. Main outcome measures: To compare for each dextrose concentration the time to achieve a Glasgow Coma Scale (GCS) score of 15, and the dose required to obtain a blood glucose level of ⩾4.5 mmol/l. Results: There were no statistically significant differences between the groups with regard to age or sex, median pretreatment GCS, pretreatment blood glucose level, or proportion of patients with insulin dependent diabetes. Following treatment, there were no statistically significant differences in median time to recovery (8 minutes), median post-treatment GCS, or number of subjects experiencing a further hypoglycaemic episode within 24 hours (four per group). The median total dose of dextrose administered was significantly less with the 10% concentration (10% = 10 g, 50% = 25 g, p
ISSN:1472-0205
1472-0213
DOI:10.1136/emj.2004.020693