BMJ 1994;308:624-626 (5 March)

Papers

Management of acute diarrhoea in diabetic patients using oral rehydration solutions containing glucose, rice, or glycine

R Haider, A K Azad Khan, S K Roy, N Dewan, A N Alam, D Mahalanabis 

International Centre for Diarrhoeal Disease Research, Bangladesh, Box 128, Dhaka 1000, Bangladesh Bangladeshi Institute for Rehabilitation of Diabetes and Endocrine Metabolic Disorders, Bangladesh Correspondence to: Dr Haider.

Abstract

Objective : To assess the risk of hyperglycaemia with two standard oral rehydration solutions that contain carbohydrate compared with a carbohydrate free solution during rehydration of diabetic patients with acute diarrhoea.
Design : Prospective randomised allocation to one of three oral rehydration solutions (World Health Organisation (glucose), rice, or glycine) groups after admission to hospital with acute diarrhoea.
Setting : Dhaka hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh.
Subjects : 45 diabetic patients aged between 15 and 60 who had had diarrhoea for fewer than three days on admission.
Main outcome measures : Fluctuation of blood glucose concentrations measured three times a day, daily stool output, and time taken for recovery from diarrhoea.
Results : There were no significant differences in blood glucose concentrations, stool output, and duration of recovery from diarrhoea among the three groups.
Conclusions : Oral rehydration solutions containing glucose, rice powder, or glycine can be safely administered to diabetic patients with acute diarrhoea and some dehydration.

Clinical implications

  • Clinical implications

  • Diabetic subjects in the developing world are also prone to diarrhoea

  • Oral rehydration solutions should be advocated for management of acute watery diarrhoea

  • In this study blood glucose concentrations were similar in diabetic patients given oral rehydration solutions whether or not they contained carbohydrate

  • Diabetic patients can safely take oral rehydration solutions at home during episodes of acute diarrhoea and avoid unnecessary admission to hospital


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