Effects Of New Intravenous Infusions On Blood Glucose Variability In Elderly Type 2 Diabetic Patients

ObjectiveTo investigate the influence of intravenous infusion of 0.9% normal saline,5% fructose,10% xylitol and 5% glucose (I:G=1:3.3) on blood glucose variability in elderly type 2 diabetic patients and provide some evidence for the selection of solutions for rehydration.MethodData of 36 elderly patients with type 2 diabetes mellitus were recruited for the study. From 9am to 11am, all the subjects were administrated one of the four kinds of solutions at constant speed on consecutive days randomly:0.9% normal saline 200ml, or 5% fructose injection 200ml, or 10% xylitol 200ml, or5% glucose injection (I:G=1:3.3) 200ml. The blood glucose concentration was determined at every 5 minutes after infusion by continuous glucose monitoring system (CGMS). The variability of blood glucose was compared using these 4 kinds of solution. A two-tailed P value of <0.05 was considered statistically significant. Statistical analysis was carried out with SPSS version 18.0.Result1.The effect on blood variability of normal saline,5%glucos (I:G=1:3.3), fructose and xylitol had no significant difference.2.The mean blood glucose levels 1 h before continuous glucose monitoring (1hMBG), maximum (Max), minimum (Min) of blood glucose, mean amplitude of glycemic excursions (MAGE), standard deviation of blood glucose (SDBG) and area under curve (AUC) of patients using normal saline, fructose, xylitol,5%glucose(I:G=1:3.3) were as follows:1hMBG [(7.70±1.51) mmol/L vs (8.22±2.29) mmol/L vs (8.82±2.53) mmol/L vs (7.51±1.19) mmol/L], Max [( 9.78±2.42) mmol/L vs (9.43±2.26) mmol/L vs (9.81±1.81) mmol/L vs (9.94±2.21) mmol/L], Min [(5.97±1.78) mmol/L vs (6.46±1.88 ) mmol/L vs (6.34±1.91) mmol/L vs (5.91±1.73) mmol/L], MAGE [(3.89±2.58) mmol/L vs (3.05±2.23) mmol/L vs (3.61±2.22) mmol/L,vs (4.08±2.57) mmol/L], SDBG [(1.15±0.71) mmol/L vs (3.05±2.23) mmol/L vs (3.61±2.22) mmol/L vs (4.08±2.57) mmol/L] and AUC [(1401.99±342.44) mmol·min/L vs ( 1416.81±355.52) mmol·min/L vs (1432.92±240.14) mmol·min/L,(1406.08±312.42) mmol·min/L], correspondingly. No significant difference of 1hMBG, Max, Min MAGE, SDBG or AUC was found between four groups of patients using these 4 kinds of solutions. In addition, no adverse effects were reported.3. Compared with normal saline, xylitol and fructose could lower the blood glucose a little after intravenous infusion 75min and 85min, while 5% glucose (I:G=1:3.3) could elevate blood glucose a little within a short time, then gradually decreased to normal after about 105min. But all of them had without significant difference.Conclusion1. Low dosageⅣadministration of fructose, xylitol and 5% glucose (I:G=1:3.3) for short-term had little effect on blood variability of patients with elderly type 2 diabetes mellitus.2. Compared with 5% glucose (I:G=i:3.3), low dosageⅣadministration of fructose and xylitol can lower the blood glucose a little but without significant difference. It was unnecessary and not economical to choose fructose or xylitol just for reducing blood glucose variability.