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Drugs - glucose vs. fructose

Q: While administering fructose i.v, do we have to give insulin to the patient? If yes, what is the ratio/why do we use fructose instead of dextrose if we have to use insulin along with it?

A:Thank you for your query though i must confess I was a little confused by your question mainly because you do not state the condition for which you would give iv fructose. I presume it is intended for intravenous nutrition but even in that condition one would give glucose or dextrose which would provide enough calories (3.4kcal/gram) for the requrements of the brain. 150 grams would suffice and you would not need to give insulin unless the patient is insulin deficient (type 1 diabetes mellitus). However, blood sugar should be monitored and insulin given if the level rises. Fructose is given if there is a danger of producing non ketotic hyper-osmolar coma with glucose particularly in diabetic patients.


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