10% vs 50% dextrose: Which is better for hypoglycaemia treatment in prehospital setting?

No significant difference exists in the need for dextrose retreatment prior to hospital arrival between 10% (D10) and 50% dextrose (D50) for the treatment of hypoglycaemia by emergency medical services (EMS), a study has shown.

“The use of D50 resulted in a significantly higher blood glucose concentrations both in the prehospital setting and upon hospital arrival,” the authors said.

This retrospective cohort study compared the safety and efficacy of the administration of D10 intravenously (IV) and D50 IV for the treatment of hypoglycaemia in the prehospital setting. Patients who received IV dextrose by EMS were included and transported to an academic teaching hospital emergency department between 2014 and 2017.

A total of 478 patients were eligible for review, of which 161 received D10 and 150 D50. No significant difference was observed in the need for dextrose retreatment prior to hospital arrival between the D10 and D50 groups (0.6 percent vs 2.0 percent; p=0.565).

Prehospital reassessment glucose in patients receiving D50 was significantly higher than in those receiving D10 (151.9 vs 124.6 mg/dL; p=0.001), and such difference persisted on hospital arrival (129.5 vs 108.0 mg/dL; p=0.011).

In addition, there was no difference seen between dextrose groups in terms of hospital admission, length of stay, or in-hospital mortality.

“Further study is needed in larger patient populations to evaluate the use of D10, the need for dextrose readministration, and its impact on clinical outcomes,” the authors said.