This single-center retrospective cohort study compared D10 vs. D50 dextrose for treating hypoglycemia (BG <70 mg/dL) in adult ED patients (n=375), evaluating time to euglycemia, rebound hypoglycemia, and hyperglycemia within 6 hours.
D50 showed a nonsignificant reduction in time to euglycemia vs. D10 (38.0 vs. 51.0 min, p=0.053), but caused significantly more rebound hypoglycemia (43.4% vs. 27.2%, p=0.002); in severe hypoglycemia (BG <40 mg/dL), time to euglycemia was identical (34.5 vs. 34.5 min, p=0.655).
Single-center retrospective design limits generalizability and introduces selection bias; the primary outcome did not reach statistical significance, leaving the speed advantage of D50 unconfirmed; the severe hypoglycemia subgroup was likely underpowered.
D10 may be the safer first-line choice for ED hypoglycemia management given its significantly lower rate of rebound hypoglycemia, without a statistically meaningful trade-off in time to euglycemia. Clinicians should weigh D50's potential speed advantage (especially in severe cases) against the nearly doubled risk of rebound hypoglycemia.
