Anaphylactoid reaction to 50% solution of dextrose

Two patients with extrinsic asthma and coexistent insulin-dependent diabetes mellitus sustained an anaphylactoid reaction after the intravenous administration of 50% solution of dextrose. Investigations suggested that the dextrose, rather than any additives, was responsible for the reaction. The effect of varying concentrations of dextrose on the histamine content of the blood of normal, allergic, non-diabetic and diabetic, and non-allergic patients was studied. Preliminary results suggest that the higher concentrations of dextrose induce increased histamine release from blood cells, and that this phenomenon is more marked in diabetic, and particularly diabetic-allergic, individuals. We suggest that the treatment of hypoglycaemia with 50% solution of dextrose is associated with a significant risk factor in those diabetic individuals who are either allergic or are receiving beta-adrenoreceptor blocking drugs.