Compendium of the most significant studies with reference to properties, intake, effects.

Saunajoki A, Auvinen J, Bloigu A, Ukkola O, Keinänen-Kiukaanniemi S, Timonen M. One-hour post-load glucose improves the prediction of cardiovascular events in the OPERA study. Ann Med. 2021 Dec;53(1):478-484. doi: 10.1080/07853890.2021.1902557.

Abstract. Background: To estimate the ability of fasting, 1-h, and 2-h post-load glucose to predict cardiovascular outcomes. Methods: We examined a population-based study consisting of 977 middle-aged subjects who underwent an oral glucose tolerance test with glucose values measured at 0, 60, and 120 min. Participants were followed up to 24 years, and cardiovascular outcomes were collected from national registers. Predictive abilities of fasting, 1-h, and 2-h glucose were evaluated alone and in the prediction models with traditional cardiovascular risk factors using Cox proportional hazard models, the likelihood-ratio test, Harrell's concordance index and integrated discrimination improvement. Results: Cardiovascular endpoint occurred in 222 (22.7%) participants during a median follow-up of 19.8 years. In the prognostic models, 1-h glucose (HR 1.67, 95%CI 1.10-2.53), but not fasting or 2-h glucose, predicted cardiovascular events statistically significantly. In addition, when adding glucose parameters into the model including traditional cardiovascular risk factors, only 1-h glucose improved the predictive ability (LR-test p=.046). Finally, 1-h glucose found slightly over 50% more cardiovascular endpoints that were not recognized by fasting or 2-h glucose levels. Conclusions: Our findings support the earlier ones suggesting that 1-h glucose would be a better long-term predictor of cardiovascular morbidity and mortality than fasting or 2-h glucose.KEY MESSAGESIn addition to conventional CV risk factors,1-h but not fasting or 2-h post-load glucoses seems to be an independent predictor of cardiovascular events and seems to improve the predictive ability of the traditional cardiovascular risk model.Elevated 1-hpost-load glucose finds a large number (slightly over 50%)of cardiovascular endpoints that were not recognized by fasting or 2-h post-load glucose levels.One-hour glucose seems to be a better long-term predictor of cardiovascular morbidity and mortality than fasting or 2-h post-load glucose.

Tonelli J, Kishore P, Lee DE, Hawkins M. The regulation of glucose effectiveness: how glucose modulates its own production. Curr Opin Clin Nutr Metab Care. 2005 Jul;8(4):450-6. doi: 10.1097/01.mco.0000172588.47811.63.

Abstract. Purpose of review: 'Glucose effectiveness' refers to the ability of glucose per se to suppress endogenous glucose production and stimulate glucose uptake. In addition to the inhibitory effects of insulin on endogenous glucose production, rising glucose levels have important direct effects on glucose homeostasis. The loss of glucose effectiveness in type 2 diabetes mellitus contributes importantly to hyperglycemia in those individuals. Given the rapidly increasing incidence and serious complications of type 2 diabetes mellitus, understanding the regulation of glucose effectiveness has great potential therapeutic benefits....Summary: The regulation of glucose effectiveness involves a complex interplay of hormonal and metabolic factors, with free fatty acid and glucoregulatory hormones playing key roles. The loss of this regulation in type 2 diabetes mellitus contributes importantly to hyperglycemia, and may largely be caused by increased free fatty acid levels.

Weston PJ, Harris DL, Battin M, Brown J, Hegarty JE, Harding JE. Oral dextrose gel for the treatment of hypoglycaemia in newborn infants. Cochrane Database Syst Rev. 2016 May 4;(5):CD011027. doi: 10.1002/14651858.CD011027.pub2. Update in: Cochrane Database Syst Rev. 2022 Mar 18;3:CD011027. .

Abstract. Background: Neonatal hypoglycaemia, a common condition, can be associated with brain injury. It is frequently managed by providing infants with an alternative source of glucose, given enterally with formula or intravenously with dextrose solution. This often requires that mother and baby are cared for in separate environments and may inhibit breast feeding. Dextrose gel is simple and inexpensive and can be administered directly to the buccal mucosa for rapid correction of hypoglycaemia, in association with continued breast feeding and maternal care. Objectives: To assess the effectiveness of dextrose gel in correcting hypoglycaemia and in reducing long-term neurodevelopmental impairment....Authors' conclusions: Treatment of infants with neonatal hypoglycaemia with 40% dextrose gel reduces the incidence of mother-infant separation for treatment and increases the likelihood of full breast feeding after discharge compared with placebo gel. No evidence suggests occurrence of adverse effects during the neonatal period or at two years' corrected age. Oral dextrose gel should be considered first-line treatment for infants with neonatal hypoglycaemia.

Tsai SW, Hsu YJ, Lee MC, Huang HE, Huang CC, Tung YT. Effects of dextrose prolotherapy on contusion-induced muscle injuries in mice. Int J Med Sci. 2018 Jul 30;15(11):1251-1259. doi: 10.7150/ijms.24170.

Abstract. Current treatment options for muscle injuries remain suboptimal and often result in delayed/incomplete recovery of damaged muscles. In this study, the effects of dextrose prolotherapy on inflammation and regeneration of skeletal muscles after a contusion injury were investigated. Mice were separated into five groups, including a normal control (NC), post-injury with no treatment (mass-drop injury, MDI), post-injury with 10% dextrose (MDI + 10% dextrose), post-injury with 20% dextrose (MDI + 20% dextrose), and post-injury with 30% dextrose (MDI + 30% dextrose). The gastrocnemius muscles of the mice were subjected to an MDI, and muscle samples were collected at 7 days post-injury. Results showed the serum creatine kinase (CK), blood urea nitrogen (BUN), creatinine (CREA), and low-density lipoprotein (LDH) of the MDI-alone group were significantly higher than those of the normal control group (p<0.05). However, levels of serum CK, BUN, CREA, and lactate dehydrogenase (LDH) significantly decreased with different concentrations of dextrose. In addition, dextrose suppressed the macrophage response (F4/80 protein decreased) and promoted muscle satellite cell regeneration (desmin protein increased). In conclusion, dextrose prolotherapy can effectively help repair muscles; therefore, it may be one of the methods for clinically treating muscle injuries.

Chou Y, Chiou HJ, Wang HK, Lai YC. Ultrasound-guided dextrose injection treatment for chronic myofascial pain syndrome: A retrospective case series. J Chin Med Assoc. 2020 Sep;83(9):876-879. doi: 10.1097/JCMA.0000000000000339.

Abstract. Background: Due to the lack of an evidence-based consensus, managing refractory myofascial pain syndrome is challenging for clinicians. Dextrose injection (dextrose prolotherapy) emerged as a promising, cost-effective treatment. This study evaluated the efficacy of targeted ultrasound-guided dextrose injection for localized myofascial pain syndrome.....Conclusion: Targeted ultrasound-guided dextrose injection was remarkably effective for refractory localized myofascial pain syndrome, significantly reducing symptom intensities in the majority of treated patients within 1 month after a single injection.

Salman N, Aykut A, Sabuncu Ü, Şaylan A, Yağar S, Şekerci S. Dextrose administration may reduce the incidence of postoperative nausea and vomiting after laparoscopic cholecystectomy: a double blind randomized controlled trial. Minerva Anestesiol. 2020 Apr;86(4):379-386. doi: 10.23736/S0375-9393.20.13484-9.

Abstract. Background: Postoperative nausea and vomiting (PONV) is the most common and undesirable of the complications associated with anesthesia, leading to discomfort in patients and extended hospital stays. The present study evaluates and compares the effects of preoperative/intraoperative dextrose infusion on PONV in patients undergoing laparoscopic cholecystectomy (LC)....Conclusions: Preoperative dextrose infusion may be suggested for PONV prophylaxis as a safe and effective method following LC.

Panda S. Circadian physiology of metabolism. Science. 2016 Nov 25;354(6315):1008-1015. doi: 10.1126/science.aah4967. 

Abstract. A majority of mammalian genes exhibit daily fluctuations in expression levels, making circadian expression rhythms the largest known regulatory network in normal physiology. Cell-autonomous circadian clocks interact with daily light-dark and feeding-fasting cycles to generate approximately 24-hour oscillations in the function of thousands of genes. Circadian expression of secreted molecules and signaling components transmits timing information between cells and tissues. Such intra- and intercellular daily rhythms optimize physiology both by managing energy use and by temporally segregating incompatible processes. Experimental animal models and epidemiological data indicate that chronic circadian rhythm disruption increases the risk of metabolic diseases. Conversely, time-restricted feeding, which imposes daily cycles of feeding and fasting without caloric reduction, sustains robust diurnal rhythms and can alleviate metabolic diseases. These findings highlight an integrative role of circadian rhythms in physiology and offer a new perspective for treating chronic diseases in which metabolic disruption is a hallmark. Copyright © 2016, American Association for the Advancement of Science.