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[Fructose metabolism disorders and infusions].

V Palyza1, M Bocková

  • 1Biochemický ústav. Lékarská fakulta MU, Brno.

Vnitrni Lekarstvi
|August 1, 1992
PubMed
Summary

Parenteral nutrition using fructose or sorbitol can cause dangerous hypoglycemia in individuals with hereditary fructose intolerance. These non-glucose energy sources should be avoided to prevent severe health complications.

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Area of Science:

  • Biochemistry
  • Clinical Nutrition
  • Metabolic Disorders

Context:

  • Parenteral nutrition is crucial for patients unable to consume food orally, especially during critical illness or post-surgery.
  • Non-glucose energy sources like fructose and D-glucitol (sorbitol) are sometimes considered for parenteral nutrition.
  • Hereditary fructose intolerance is a genetic metabolic disorder affecting fructose metabolism.

Purpose:

  • To review the metabolic pathways of fructose and its associated disorders.
  • To evaluate the safety and efficacy of non-glucose energy sources in parenteral nutrition, particularly in the context of hereditary fructose intolerance.
  • To discuss the risks of administering fructose and D-glucitol (sorbitol) to susceptible individuals.

Summary:

  • Fructose and D-glucitol (sorbitol) metabolism can lead to life-threatening hypoglycemia in patients with hereditary fructose intolerance, even without prior diagnosis.
  • Hepatic and renal failure are potential complications, possibly independent of hypoglycemia, in individuals with this intolerance.
  • Current evidence suggests avoiding fructose and D-glucitol (sorbitol) in parenteral nutrition due to these risks, a view supported by their removal from some pharmacopoeias.

Impact:

  • Highlights the critical need for careful consideration of non-glucose energy sources in parenteral nutrition, especially in vulnerable patient populations.
  • Informs clinical practice regarding the contraindications of fructose and D-glucitol (sorbitol) in parenteral nutrition for individuals with undiagnosed hereditary fructose intolerance.
  • Contributes to patient safety by advocating for the exclusion of potentially harmful substances from therapeutic regimens.

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