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  • Title: The effect of 25 grams i.v. glucose on serum inorganic phosphate levels.
    Author: MacLeod DB, Montoya DR, Fick GH, Jessen KR.
    Journal: Ann Emerg Med; 1994 Mar; 23(3):524-8. PubMed ID: 8135428.
    Abstract:
    STUDY OBJECTIVE: To determine whether a 25-g IV glucose bolus will result in a fall in serum inorganic phosphate levels. DESIGN: Single-blind, randomized, controlled trial. PARTICIPANTS: Thirty-six healthy, nondiabetic, adult volunteers. INTERVENTIONS: Random allocation to a control group receiving a 50-mL normal saline bolus followed by a normal saline infusion at 125 mL/hr for three hours; study group 1, receiving a 50-mL bolus of D50W followed by a normal saline infusion at 125 mL/hr for three hours; or study group 2, receiving a 50-mL bolus of D50W followed by an infusion of 2/3:1/3 dextrose:saline solution at 125 mL/hr for three hours. MEASUREMENTS AND MAIN RESULTS: Serum inorganic phosphate levels were measured at time zero (baseline) and at 30-minute intervals for three hours. There was a statistically significant fall in serum inorganic phosphate levels in both groups receiving the glucose bolus. The group receiving the glucose infusion demonstrated a trend toward a further decline in serum phosphate levels. CONCLUSION: A glucose bolus and infusion in the amounts compatible with what is given to patients with altered levels of consciousness produced a significant fall in serum inorganic phosphate levels in healthy, nondiabetic adults. Because hypophosphatemia may create a clinical picture of altered mental status very similar to that of hypoglycemia, consideration should be given to administering IV glucose only to patients with finger-stick-proven hypoglycemia. Consideration also should be given to monitoring phosphate levels after administration of IV glucose.
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