Why do docs give D5 to diabetic patients a lot?

**RosesrReder, BSN, MSN, RN** · Jun 28, 2007

What are the pt's other comorbidities? HTN?

Shell5 · Jun 29, 2007

no HTN.

meownsmile, BSN, RN · Jun 30, 2007

What is their nutritional status? If a diabetic isnt eating or eating poorly they may use D5 to keep the blood sugar from bottoming out. The balance sometimes is better than constantly adjusting their insulin dose.

StacieRN, RN · Jun 30, 2007

It's standard to use D5 for surgical diabetic patients. Due to NPO status, post-op N/V, possible anorexia, and increased caloric need while healing.

The risk for infection is decreased with tighter blood sugar control. Many surgeons will stop oral hypoglycemics and use scheduled and sliding scale insulin.

The D5 only provides 400 calories in 24 hours if going at 100cc/hr. It's not enough to cause hyperglycemia. But is enough to help with the previously listed problems.

leslie :-D · Jul 1, 2007

informative link (hope it works)

http://www.findarticles.com/p/articles/mi_qa3689/is_199810/ai_n8826281

leslie

icie rn, ADN, RN · Jul 7, 2007

Agree with above posters, being a diabetic myself, I know that when I am ill, I need extra means of nutrients because my oral intake is often well below what is good for me. D5W does not have a 1:1 ratio in calories per ml. So when ill, diabetics often benefit from this little added boost of sugar since it is not a lot.

sarita279 · Jul 13, 2007

as others have already mentioned, D5 doesn't supply a large amount of dextrose. i learned in a diabetes class that it only supplies about 5g of sugar, which is equivalant to a lifesaver/hr when run at approx. 100ml/hr.

leslie :-D · Jul 14, 2007

giving d10 and up, would warrant closer monitoring of pt's glucose.

leslie

ginger58, ASN, RN · Nov 7, 2007

D5 is an isotonic solution.

http://www.efn.org/~nurses/IVF.html

Daytonite, BSN, RN · Nov 10, 2007

it has nothing to do with the dextrose in it and everything to do with it's tonicity and osmolality. 5% dextrose and water is isotonic, has an osmolarity of 253, ph of about 4.5 to 5.0 and provides 170 calories per liter and free water. this water is able to cross all cell and tissue membranes to go into the various fluid compartments where is it needed. if the patient needs calories solutions containing higher concentrations of dextrose would be given.

isotonic solutions have the same tonicity as plasma so that when they are infused into a vein, water neither enters or leaves the cells. they have the same concentration as blood. these kinds of iv solutions are used to expand the extracellular fluid volume and do not cause any fluid to move from into or out of the blood cells. isotonic solutions have an osmolality of 240 to 340 mosm/liter.

i know you're thinking that if the patient is a diabetic the doctor should be giving them saline. however, problems with using continuous iv solutions of strictly sodium chloride include

hyponatremia (with continuous infusions of 0.45%)
calorie depletion
hypernatremia (with continuous infusion of the higher percentage nacl solutions)
peripheral edema
an exhaustion of other body electrolytes
hyperchloremia

Nrs_angie, BSN, RN · Nov 15, 2007

Hi there,

While I do agree with what Daytonite and the other poster mentioned about it being an Isotonic solution... I also agree with what the one poster said about using it for surgery patients. Surgery usually d/c's the oral hypoglycemics because they tend to be longer-acting. They wouldn't want the pt to bottom out. Hence, they will put the patient on a sliding scale insulin which is usually shorter-acting. This allows for tighter control of blood sugar of diabetic prior to surgery who will be on NPO status.