DEXTROSE

DEXTROSE

Dextrose, as intravenous sugar solution, is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system. It is also on the list in combination with sodium chloride.

CAS No. : 50-99-7
EC No. : 200-075-1

Synonyms:
glucose; dekstroz; dextros; dextroz; Blood sugar; Dextrose; Corn sugar; d-Glucose; Grape sugar; (2R,3S,4R,5R)-2,3,4,5,6-Pentahydroxyhexanal; ᴅ-Glucose; ᴅ-gluco-Hexose; D-Glc; D-Glucopyranose; D-Glucopyranoside; D-Glucose; Glc; Glucopyranose; Glucopyranoside; Glucose; Grape sugar; 2280-44-6; Glucodin; Meritose; Clintose L; CPC hydrate; Roferose ST; a-D-Glucose; Clearsweet 95; Staleydex 95M; D-Glcp; (3R,4S,5S,6R)-6-(hydroxymethyl)oxane-2,3,4,5-tetrol; (+)-Glucose; CHEBI:4167; Glucose solution; Glucopyranose, D-; D-glucose (closed ring structure, complete stereochemistry); 492-62-6; 2h-pyran-2,3,4,5-tetraol; D-Glucopyranose, anhydrous; glc-ring; Cartose Cerelose; D-aGlucopyranose; D-glucose-ring; Glucose injection; Glucose 40; Staleydex 130; EINECS 218-914-5; Glc-OH; Meritose 200; Dextrose; nchembio867-comp4; Glucose (JP17); 6-(hydroxymethyl)tetrahydropyran-2,3,4,5-tetraol; Anhydrous Glucose ,(S); Purified glucose (JP17); Epitope ID:142342; D-(+)-DEXTROSE; (3R,4S,5S,6R)-6-(hydroxymethyl)tetrahydro-; D(+)-Glucose; 50-99-7; (2R,3S,4R,5R)-2,3,4,5,6-pentahydroxyhexanal; aldehydo-D-glucose; Blood sugar; Dextrose Anhydrous; Glucose, anhydrous; D-Glucose In Linear Form; Dextrose, anhydrous; D-Glucose, anhydrous; Glucosteril; Anhydrous dextrose; Dextrose solution; Maxim Energy Gel; Cartose; Cerelose; Staleydex 333; Dextropur; Dextrosol; Glucolin; Sirup; Glucose liquid; anhydrous dextrose (open form); Sugar, grape; Dextrose (polymer); Glucose Polymer; Dextrose (D-Glucose) Anhydrous; DL-Glucose; Glucans; Glucopur; Maxijul; Synthetic glucan; Poly-D-glucose; Dextrose; D-Glucose polymer; Glucose homopolymer; GLO; D-Glucose, polymers; (14C)-Glucose; (14C)D-Glucose; (C13)D-Glucose; (U-14C)Glucose; 28823-03-2; D-Glucose, homopolymer; Glucose (C-13); Glucose (C-14); D-(U-14C)Glucose; (U-13C)-D-glucose; D-Glucose, labeled with tritium; linear D-glucose; D(+)-Glucose, anhydrous, specificied according to the requirements of Ph.Eur., USP, BP; 25191-16-6; D-Glucose, labeled with carbon-13; D-Glucose, labeled with carbon-14; Glucose [JAN]; NSC 83659; D-Glucose - anhydrous; UREA-FORMALDEHYDERESIN; CHEMBL448805; Dextrosum (Glucosum) anhydricum; D-Glucose;Grape sugar;Glucopyranose; D(+)-Glucose, ACS reagent, anhydrous; D-(+)-Glucose, 1M aqueous solution, sterile; D-GLUCOSE,2-(ACETYLAMINO)-4-O-[2-(ACETYLAMINO)-2-DEOXY-4-O-SULFO-B-D-GALACTOPYRANOSYL]-2-DEOXY-

Dextrose

Dextrose is a simple sugar with the molecular formula C6H12O6. Dextrose is the most abundant monosaccharide, a subcategory of carbohydrates. Dextrose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using energy from sunlight, where it is used to make cellulose in cell walls, which is the most abundant carbohydrate. In energy metabolism, Dextrose is the most important source of energy in all organisms. Dextrose for metabolism is stored as a polymer, in plants mainly as starch and amylopectin, and in animals as glycogen. Dextrose circulates in the blood of animals as blood sugar. The naturally occurring form of Dextrose is d-Dextrose, while l-Dextrose is produced synthetically in comparatively small amounts and is of lesser importance. Dextrose is a monosaccharide containing six carbon atoms and an aldehyde group, and is therefore an aldohexose. The Dextrose molecule can exist in an open-chain (acyclic) as well as ring (cyclic) form. Dextrose is naturally occurring and is found in fruits and other parts of plants in its free state. In animals, Dextrose is released from the breakdown of glycogen in a process known as glycogenolysis.

The name Dextrose derives through the French from the Greek γλυκός ('glukos'), which means "sweet", in reference to must, the sweet, first press of grapes in the making of wine. The suffix "-ose" is a chemical classifier, denoting a sugar.

What is dextrose?
Dextrose is the name of a simple sugar that is made from corn and is chemically identical to glucose, or blood sugar. Dextrose is often used in baking products as a sweetener, and can be commonly found in items such as processed foods and corn syrup.

Dextrose also has medical purposes. It is dissolved in solutions that are given intravenously, which can be combined with other drugs, or used to increase a person’s blood sugar. Because dextrose is a “simple” sugar, the body can quickly use it for energy. Simple sugars can raise blood sugar levels very quickly, and they often lack nutritional value. Examples of other simple sugars include glucose, fructose, and galactose. Products that are typically made of simple sugars include refined sugar, white pasta, and honey.

What are common dextrose preparations?
Dextrose is used to make several intravenous (IV) preparations or mixtures, which are available only at a hospital or medical facility. Dextrose is also available as an oral gel or in oral tablet form over the counter from pharmacies. Each dextrose concentration has its own unique uses. Higher concentrations are typically used as “rescue” doses when someone has a very low blood sugar reading.

How is dextrose used?
Dextrose is used in various concentrations for different purposes. For example, a doctor may prescribe dextrose in an IV solution when someone is dehydrated and has low blood sugar. Dextrose IV solutions can also be combined with many drugs, for IV administration.

Dextrose is a carbohydrate, which is one part of nutrition in a normal diet. Solutions containing dextrose provide calories and may be given intravenously in combination with amino acids and fats. This is called total parenteral nutrition (TPN) and is used to provide nutrition to those who cannot absorb or get carbohydrates, amino acids, and fats through their gut.

High-concentration dextrose injections are only given by professionals. These injections are administered to people whose blood sugar may be very low and who cannot swallow dextrose tablets, foods, or drinks.

If a person’s potassium levels are too high (hyperkalemia), sometimes doctors also give dextrose injections of 50 percent, followed by insulin intravenously. This may be done in the hospital setting. When the cells take in the extra glucose, they also take in potassium. This helps to lower a person’s blood potassium levels. The dextrose is given to prevent the person from being hypoglycemic. The insulin is treating the elevated potassium.

People with diabetes or hypoglycemia (chronically low blood sugar) may carry dextrose gel or tablets in case their blood sugar gets too low. The gel or tablets dissolve in a person’s mouth and quickly boost blood sugar levels. If a person’s blood sugar is less than 70 mg/dL and they are having low blood sugar symptoms, they may need to take the dextrose tablets. Examples of low blood sugar symptoms include weakness, confusion, sweating, and too-fast heart rate.

What precautions should I take when using dextrose?
A medical provider should not give dextrose to people with certain kinds of medical conditions. This is because the dextrose could potentially cause too-high blood sugar or fluid shifts in the body that lead to swelling or fluid buildup in the lungs.

Avoid dextrose
if you have hyperglycemia, or high blood sugar
if you have hypokalemia, or low potassium levels in the blood
if you have peripheral edema, or swelling in the arms, feet, or legs
if you have pulmonary edema, when fluids build up in the lungs
If you are diabetic and your doctor prescribes dextrose oral gel or tablets for you, these should only be used when you have a low blood sugar reaction. Your doctor or diabetes educator should teach you how to spot the signs of low blood sugar and when to use the tablets. If you need to have the gel or tablets on hand, you should keep them with you at all times and you should keep some at home. Your doctor should also explain to other family members when to use the gel or tablets, in case others need to give them to you.
If you have an allergy to corn, you could have an allergic reaction to dextrose. Talk to your doctor before using it.

Monitoring your blood sugar while on dextrose
Even if you don’t have certain conditions, it is important to continually check your blood sugar if they are receiving dextrose. This can ensure that the dextrose does not dangerously increase blood sugar. You can check your blood sugar with home tests. They involve testing blood from a finger prick on a blood strip. For those who are physically unable to test their blood at home, urine glucose tests are available, though they’re not as reliable.

If you do find that you or someone else is having a negative reaction due to low blood sugar, the dextrose tablets should be taken immediately. According to the Joslin Diabetes Center, four glucose tablets are equal to 15 grams of carbs and can be taken in the case of low blood sugar levels (unless otherwise advised by your doctor). Chew the tablets thoroughly before swallowing. No water is needed. Your symptoms should improve within 20 minutes. If they don’t, consult your doctor.

The dextrose gel often comes in single-serving tubes, which are poured directly into the mouth and swallowed. If you haven’t felt any positive changes after 10 minutes, repeat with another tube. If your blood sugar is still too low after an additional 10 minutes, contact your doctor.

Dextrose in children
Dextrose can be used in children similarly to how it is used in adults, as a medical intervention for hypoglycemia. In cases of severe pediatric hypoglycemia, children will often be given dextrose intravenously. Prompt and early treatment in children and infants with hypoglycemia is essential, as untreated hypoglycemia can result in neurological damage. If they’re able to take it, dextrose may be given to children orally.

In the case of neonatal hypoglycemia, which can be caused by several disorders such as metabolism defects or hyperinsulinism, infants can have small amounts of dextrose gel added to their diet to help them maintain healthy blood sugar levels. Consult your doctor for how much dextrose to add to their diet. Infants that were born prematurely are at risk for hypoglycemia, and may be given dextrose via an IV.

Dextrose powder and bodybuilding
Dextrose is naturally calorie-dense and easy for the body to break down for energy. Because of this, dextrose powder is available and sometimes used as a nutritional supplement by bodybuilders who are looking to increase weight and muscle.

While the boost in calories and easy to break down nature of dextrose can benefit bodybuilders or those looking to increase muscle mass, it’s important to note that dextrose lacks other essential nutrients that are needed to accomplish this goal. Those nutrients include protein and fat. Dextrose powder’s simple sugars also make it easier to break down, while complex sugars and carbohydrates may benefit bodybuilders more, as they are more successful at helping fat to burn.

What are the side effects of dextrose?
Dextrose should be carefully given to people who have diabetes, because they might not be able to process dextrose as quickly as would someone without the condition. Dextrose can increase the blood sugar too much, which is known as hyperglycemia.

Symptoms include:
fruity odor on the breath
increasing thirst with no known causes
dry skin
dehydration
nausea
shortness of breath
stomach upset
unexplained fatigue
urinating frequently
vomiting
confusion
Effect on blood sugar
If you need to use dextrose, your blood sugar could increase too much afterward. You should test your blood sugar after using dextrose tablets, as directed by your doctor or diabetes educator. You may need to adjust your insulin to lower your blood sugar.

If you are given IV fluids with dextrose in the hospital, your nurse will check your blood sugar. If the blood sugar tests too high, the dose of your IV fluids may be adjusted or even stopped, until your blood sugar reaches a safer level. You could also be given insulin, to help reduce your blood sugar.

Dextrose’s simple sugar composition makes it useful as a treatment for hypoglycemia and low blood sugar for patients of all ages, with some treatment options being convenient and portable. It is safe to use long-term on an as-needed basis. Dextrose does not come without risks, however, and even those without diabetes should carefully monitor their blood sugar when taking it.

Always consult a doctor before stopping treatment for diabetes, or if you test your blood sugar and it is high. If you have glucose gel or tablets in your home, keep them away from children. Large amounts taken by small children could be especially dangerous.

History of dextrose
Dextrose was first isolated from raisins in 1747 by the German chemist Andreas Marggraf. Dextrose was discovered in grapes by Johann Tobias Lowitz in 1792, and distinguished as being different from cane sugar (sucrose). Dextrose is the term coined by Jean Baptiste Dumas in 1838, which has prevailed in the chemical literature. Friedrich August Kekulé proposed the term dextrose (from Latin dexter = right), because in aqueous solution of Dextrose, the plane of linearly polarized light is turned to the right. In contrast, d-fructose (a ketohexose) and l-Dextrose turn linearly polarized light to the left. The earlier notation according to the rotation of the plane of linearly polarized light (d and l-nomenclature) was later abandoned in favor of the d- and l-notation, which refers to the absolute configuration of the asymmetric center farthest from the carbonyl group, and in concordance with the configuration of d- or l-glyceraldehyde.

Since Dextrose is a basic necessity of many organisms, a correct understanding of its chemical makeup and structure contributed greatly to a general advancement in organic chemistry. This understanding occurred largely as a result of the investigations of Emil Fischer, a German chemist who received the 1902 Nobel Prize in Chemistry for his findings. The synthesis of Dextrose established the structure of organic material and consequently formed the first definitive validation of Jacobus Henricus van 't Hoff's theories of chemical kinetics and the arrangements of chemical bonds in carbon-bearing molecules. Between 1891 and 1894, Fischer established the stereochemical configuration of all the known sugars and correctly predicted the possible isomers, applying Van 't Hoff's theory of asymmetrical carbon atoms. The names initially referred to the natural substances. Their enantiomers were given the same name with the introduction of systematic nomenclatures, taking into account absolute stereochemistry (e.g. Fischer nomenclature, d/l nomenclature).

For the discovery of the metabolism of Dextrose Otto Meyerhof received the Nobel Prize in Physiology or Medicine in 1922. Hans von Euler-Chelpin was awarded the Nobel Prize in Chemistry along with Arthur Harden in 1929 for their "research on the fermentation of sugar and their share of enzymes in this process". In 1947, Bernardo Houssay (for his discovery of the role of the pituitary gland in the metabolism of Dextrose and the derived carbohydrates) as well as Carl and Gerty Cori (for their discovery of the conversion of glycogen from Dextrose) received the Nobel Prize in Physiology or Medicine. In 1970, Luis Leloir was awarded the Nobel Prize in Chemistry for the discovery of Dextrose-derived sugar nucleotides in the biosynthesis of carbohydrates.

Chemical properties
With six carbon atoms, it is classed as a hexose, a subcategory of the monosaccharides. d-Dextrose is one of the sixteen aldohexose stereoisomers. The d-isomer, d-Dextrose, also known as dextrose, occurs widely in nature, but the l-isomer, l-Dextrose, does not. Dextrose can be obtained by hydrolysis of carbohydrates such as milk sugar (lactose), cane sugar (sucrose), maltose, cellulose, glycogen, etc. Dextrose is commonly commercially manufactured from cornstarch in the US and Japan, from potato and wheat starch in Europe, and from tapioca starch in tropical areas. The manufacturing process uses hydrolysis via pressurized steaming at controlled pH in a jet followed by further enzymatic depolymerization. Unbonded Dextrose is one of the main ingredients of honey. All forms of Dextrose are colorless and easily soluble in water, acetic acid, and several other solvents. They are only sparingly soluble in methanol and ethanol.

Structure and nomenclature
Dextrose is a monosaccharide with formula C6H12O6 or H−(C=O)−(CHOH)5−H, whose five hydroxyl (OH) groups are arranged in a specific way along its six-carbon back. Dextrose is usually present in solid form as a monohydrate with a closed pyran ring (dextrose hydrate). In aqueous solution, on the other hand, it is an open-chain to a small extent and is present predominantly as α- or β-pyranose, which partially mutually merge by mutarotation. From aqueous solutions, the three known forms can be crystallized: α-glucopyranose, β-glucopyranose and β-glucopyranose hydrate. Dextrose is a building block of the disaccharides lactose and sucrose (cane or beet sugar), of oligosaccharides such as raffinose and of polysaccharides such as starch and amylopectin, glycogen or cellulose. The glass transition temperature of Dextrose is 31 °C and the Gordon–Taylor constant (an experimentally determined constant for the prediction of the glass transition temperature for different mass fractions of a mixture of two substances) is 4.5.

Open-chain form
Dextrose can exist in both a straight-chain and ring form. In its fleeting open-chain form, the Dextrose molecule has an open (as opposed to cyclic) and unbranched backbone of six carbon atoms, C-1 through C-6; where C-1 is part of an aldehyde group H(C=O)−, and each of the other five carbons bears one hydroxyl group −OH. The remaining bonds of the backbone carbons are satisfied by hydrogen atoms −H. Therefore, Dextrose is both a hexose and an aldose, or an aldohexose. The aldehyde group makes Dextrose a reducing sugar giving a positive reaction with the Fehling test.

Each of the four carbons C-2 through C-5 is a stereocenter, meaning that its four bonds connect to four different substituents. (Carbon C-2, for example, connects to −(C=O)H, −OH, −H, and −(CHOH)4H.) In d-Dextrose, these four parts must be in a specific three-dimensional arrangement. Namely, when the molecule is drawn in the Fischer projection, the hydroxyls on C-2, C-4, and C-5 must be on the right side, while that on C-3 must be on the left side.

The positions of those four hydroxyls are exactly reversed in the Fischer diagram of l-Dextrose. d- and l-Dextrose are two of the 16 possible aldohexoses; the other 14 are allose, altrose, galactose, gulose, idose, mannose, and talose, each with two enantiomers, “d-” and “l-”. It is important to note that the linear form of Dextrose makes up less than 0.02% of the Dextrose molecules in a water solution. The rest is one of two cyclic forms of Dextrose that are formed when the hydroxyl group on carbon 5 (C5) bonds to the aldehyde carbon 1 (C1).

Cyclic forms
In solutions, the open-chain form of Dextrose (either "D-" or "L-") exists in equilibrium with several cyclic isomers, each containing a ring of carbons closed by one oxygen atom. In aqueous solution, however, more than 99% of Dextrose molecules, at any given time, exist as pyranose forms. The open-chain form is limited to about 0.25%, and furanose forms exist in negligible amounts. The terms "Dextrose" and "D-Dextrose" are generally used for these cyclic forms as well. The ring arises from the open-chain form by an intramolecular nucleophilic addition reaction between the aldehyde group (at C-1) and either the C-4 or C-5 hydroxyl group, forming a hemiacetal linkage, −C(OH)H−O−.

Optical activity
Whether in water or the solid form, d-(+)-Dextrose is dextrorotatory, meaning it will rotate the direction of polarized light clockwise as seen looking toward the light source. The effect is due to the chirality of the molecules, and indeed the mirror-image isomer, l-(−)-Dextrose, is levorotatory (rotates polarized light counterclockwise) by the same amount. The strength of the effect is different for each of the five tautomers.

Note that the d- prefix does not refer directly to the optical properties of the compound. It indicates that the C-5 chiral centre has the same handedness as that of d-glyceraldehyde (which was so labelled because it is dextrorotatory). The fact that d-Dextrose is dextrorotatory is a combined effect of its four chiral centres, not just of C-5; and indeed some of the other d-aldohexoses are levorotatory.

The conversion between the two anomers can be observed in a polarimeter since pure α-dDextrose has a specific rotation angle of +112.2°·ml/(dm·g), pure β- D- Dextrose of +17.5°·ml/(dm·g). When equilibrium has been reached after a certain time due to mutarotation, the angle of rotation is +52.7°·ml/(dm·g). By adding acid or base, this transformation is much accelerated. The equilibration takes place via the open-chain aldehyde form.

Biochemical properties
Dextrose is the most abundant monosaccharide. Dextrose is also the most widely used aldohexose in most living organisms. One possible explanation for this is that Dextrose has a lower tendency than other aldohexoses to react nonspecifically with the amine groups of proteins. This reaction—glycation—impairs or destroys the function of many proteins, e.g. in glycated hemoglobin. Dextrose's low rate of glycation can be attributed to its having a more stable cyclic form compared to other aldohexoses, which means it spends less time than they do in its reactive open-chain form. The reason for Dextrose having the most stable cyclic form of all the aldohexoses is that its hydroxy groups (with the exception of the hydroxy group on the anomeric carbon of d-Dextrose) are in the equatorial position. Presumably, Dextrose is the most abundant natural monosaccharide because it is less glycated with proteins than other monosaccharides. Another hypothesis is that Dextrose, being the only D-aldohexose that has all five hydroxy substituents in the equatorial position in the form of β-D-Dextrose, is more readily accessible to chemical reactions, for example, for esterification or acetal formation. For this reason, D-Dextrose is also a highly preferred building block in natural polysaccharides (glycans). Polysaccharides that are composed solely of Dextrose are termed glucans.

Dextrose is produced by plants through the photosynthesis using sunlight, water and carbon dioxide and can be used by all living organisms as an energy and carbon source. However, most Dextrose does not occur in its free form, but in the form of its polymers, i.e. lactose, sucrose, starch and others which are energy reserve substances, and cellulose and chitin, which are components of the cell wall in plants or fungi and arthropods, respectively. These polymers are degraded to Dextrose during food intake by animals, fungi and bacteria using enzymes. All animals are also able to produce Dextrose themselves from certain precursors as the need arises. Nerve cells, cells of the renal medulla and erythrocytes depend on Dextrose for their energy production. In adult humans, there are about 18 g of Dextrose, of which about 4 g are present in the blood. Approximately 180 to 220 g of Dextrose are produced in the liver of an adult in 24 hours.

Many of the long-term complications of diabetes (e.g., blindness, kidney failure, and peripheral neuropathy) are probably due to the glycation of proteins or lipids. In contrast, enzyme-regulated addition of sugars to protein is called glycosylation and is essential for the function of many proteins.

Uptake
Ingested Dextrose initially binds to the receptor for sweet taste on the tongue in humans. This complex of the proteins T1R2 and T1R3 makes it possible to identify Dextrose-containing food sources. Dextrose mainly comes from food - about 300 g per day are produced by conversion of food, but it is also synthesized from other metabolites in the body's cells. In humans, the breakdown of Dextrose-containing polysaccharides happens in part already during chewing by means of amylase, which is contained in saliva, as well as by maltase, lactase and sucrase on the brush border of the small intestine. Dextrose is a building block of many carbohydrates and can be split off from them using certain enzymes. Glucosidases, a subgroup of the glycosidases, first catalyze the hydrolysis of long-chain Dextrose-containing polysaccharides, removing terminal Dextrose. In turn, disaccharides are mostly degraded by specific glycosidases to Dextrose. The names of the degrading enzymes are often derived from the particular poly- and disaccharide; inter alia, for the degradation of polysaccharide chains there are amylases (named after amylose, a component of starch), cellulases (named after cellulose), chitinases (named after chitin) and more. Furthermore, for the cleavage of disaccharides, there are maltase, lactase, sucrase, trehalase and others. In humans, about 70 genes are known that code for glycosidases. They have functions in the digestion and degradation of glycogen, sphingolipids, mucopolysaccharides and poly(ADP-ribose). Humans do not produce cellulases, chitinases and trehalases, but the bacteria in the gut flora do.

In order to get into or out of cell membranes of cells and membranes of cell compartments, Dextrose requires special transport proteins from the major facilitator superfamily. In the small intestine (more precisely, in the jejunum), Dextrose is taken up into the intestinal epithelial cells with the help of Dextrose transporters via a secondary active transport mechanism called sodium ion-Dextrose symport via the sodium/Dextrose cotransporter 1. The further transfer occurs on the basolateral side of the intestinal epithelial cells via the Dextrose transporter GLUT2, as well as their uptake into liver cells, kidney cells, cells of the islets of Langerhans, nerve cells, astrocytes and tanyocytes. Dextrose enters the liver via the vena portae and is stored there as a cellular glycogen. In the liver cell, it is phosphorylated by glucokinase at position 6 to Dextrose-6-phosphate, which can not leave the cell. With the help of Dextrose-6-phosphatase, Dextrose-6-phosphate is converted back into Dextrose exclusively in the liver, if necessary, so that it is available for maintaining a sufficient blood Dextrose concentration. In other cells, uptake happens by passive transport through one of the 14 GLUT proteins. In the other cell types, phosphorylation occurs through a hexokinase, whereupon Dextrose can no longer diffuse out of the cell.

The Dextrose transporter GLUT1 is produced by most cell types and is of particular importance for nerve cells and pancreatic β-cells. GLUT3 is highly expressed in nerve cells. Dextrose from the bloodstream is taken up by GLUT4 from muscle cells (of the skeletal muscle and heart muscle) and fat cells. GLUT14 is formed exclusively in testes. Excess Dextrose is broken down and converted into fatty acids, which are stored as triacylglycerides. In the kidneys, Dextrose in the urine is absorbed via SGLT1 and SGLT2 in the apical cell membranes and transmitted via GLUT2 in the basolateral cell membranes. About 90% of kidney Dextrose reabsorption is via SGLT2 and about 3% via SGLT1.

Biosynthesis
In plants and some prokaryotes, Dextrose is a product of photosynthesis Dextrose is also formed by the breakdown of polymeric forms of Dextrose like glycogen (in animals and mushrooms) or starch (in plants). The cleavage of glycogen is termed glycogenolysis, the cleavage of starch is called starch degradation.

The metabolic pathway that begins with molecules containing two to four carbon atoms (C) and ends in the Dextrose molecule containing six carbon atoms is called gluconeogenesis and occurs in all living organisms. The smaller starting materials are the result of other metabolic pathways. Ultimately almost all biomolecules come from the assimilation of carbon dioxide in plants during photosynthesis. The free energy of formation of α-d-Dextrose is 917.2 kilojoules per mole. In humans, gluconeogenesis occurs in the liver and kidney, but also in other cell types. In the liver about 150 g of glycogen are stored, in skeletal muscle about 250 g. However, the Dextrose released in muscle cells upon cleavage of the glycogen can not be delivered to the circulation because Dextrose is phosphorylated by the hexokinase, and a Dextrose-6-phosphatase is not expressed to remove the phosphate group. Unlike for Dextrose, there is no transport protein for Dextrose-6-phosphate. Gluconeogenesis allows the organism to build up Dextrose from other metabolites, including lactate or certain amino acids, while consuming energy. The renal tubular cells can also produce Dextrose.

Dextrose degradation
In humans, Dextrose is metabolised by glycolysis and the pentose phosphate pathway. Glycolysis is used by all living organisms, with small variations, and all organisms generate energy from the breakdown of monosaccharides. In the further course of the metabolism, it can be completely degraded via oxidative decarboxylation, the Krebs cycle (synonym citric acid cycle) and the respiratory chain to water and carbon dioxide. If there is not enough oxygen available for this, the Dextrose degradation in animals occurs anaerobic to lactate via lactic acid fermentation and releases less energy. Muscular lactate enters the liver through the bloodstream in mammals, where gluconeogenesis occurs (Cori cycle). With a high supply of Dextrose, the metabolite acetyl-CoA from the Krebs cycle can also be used for fatty acid synthesis. Dextrose is also used to replenish the body's glycogen stores, which are mainly found in liver and skeletal muscle. These processes are hormonally regulated.

In other living organisms, other forms of fermentation can occur. The bacterium Escherichia coli can grow on nutrient media containing Dextrose as the sole carbon source. In some bacteria and, in modified form, also in archaea, Dextrose is degraded via the Entner-Doudoroff pathway.

Use of Dextrose as an energy source in cells is by either aerobic respiration, anaerobic respiration, or fermentation. The first step of glycolysis is the phosphorylation of Dextrose by a hexokinase to form Dextrose 6-phosphate. The main reason for the immediate phosphorylation of Dextrose is to prevent its diffusion out of the cell as the charged phosphate group prevents Dextrose 6-phosphate from easily crossing the cell membrane. Furthermore, addition of the high-energy phosphate group activates Dextrose for subsequent breakdown in later steps of glycolysis. At physiological conditions, this initial reaction is irreversible.

In anaerobic respiration, one Dextrose molecule produces a net gain of two ATP molecules (four ATP molecules are produced during glycolysis through substrate-level phosphorylation, but two are required by enzymes used during the process). In aerobic respiration, a molecule of Dextrose is much more profitable in that a maximum net production of 30 or 32 ATP molecules (depending on the organism) through oxidative phosphorylation is generated.

Energy source
Dextrose is a ubiquitous fuel in biology. It is used as an energy source in organisms, from bacteria to humans, through either aerobic respiration, anaerobic respiration (in bacteria), or fermentation. Dextrose is the human body's key source of energy, through aerobic respiration, providing about 3.75 kilocalories (16 kilojoules) of food energy per gram. Breakdown of carbohydrates (e.g., starch) yields mono- and disaccharides, most of which is Dextrose. Through glycolysis and later in the reactions of the citric acid cycle and oxidative phosphorylation, Dextrose is oxidized to eventually form carbon dioxide and water, yielding energy mostly in the form of ATP. The insulin reaction, and other mechanisms, regulate the concentration of Dextrose in the blood. The physiological caloric value of Dextrose, depending on the source, is 16.2 kilojoules per gram and 15.7 kJ/g (3.74 kcal/g), respectively. The high availability of carbohydrates from plant biomass has led to a variety of methods during evolution, especially in microorganisms, to utilize the energy and carbon storage Dextrose. Differences exist in which end product can no longer be used for energy production. The presence of individual genes, and their gene products, the enzymes, determine which reactions are possible. The metabolic pathway of glycolysis is used by almost all living beings. An essential difference in the use of glycolysis is the recovery of NADPH as a reductant for anabolism that would otherwise have to be generated indirectly.

Dextrose and oxygen supply almost all the energy for the brain, so its availability influences psychological processes. When Dextrose is low, psychological processes requiring mental effort (e.g., self-control, effortful decision-making) are impaired. In the brain, which is dependent on Dextrose and oxygen as the major source of energy, the Dextrose concentration is usually 4 to 6 mM (5 mM equals 90 mg/dL), but decreases to 2 to 3 mM when fasting. Confusion occurs below 1 mM and coma at lower levels.

The Dextrose in the blood is called blood sugar. Blood sugar levels are regulated by Dextrose-binding nerve cells in the hypothalamus. In addition, Dextrose in the brain binds to Dextrose receptors of the reward system in the nucleus accumbens. The binding of Dextrose to the sweet receptor on the tongue induces a release of various hormones of energy metabolism, either through Dextrose or through other sugars, leading to an increased cellular uptake and lower blood sugar levels. Artificial sweeteners do not lower blood sugar levels.

The blood sugar content of a healthy person in the short-time fasting state, e.g. after overnight fasting, is about 70 to 100 mg/dL of blood (4 to 5.5 mM). In blood plasma, the measured values are about 10–15% higher. In addition, the values in the arterial blood are higher than the concentrations in the venous blood since Dextrose is absorbed into the tissue during the passage of the capillary bed. Also in the capillary blood, which is often used for blood sugar determination, the values are sometimes higher than in the venous blood. The Dextrose content of the blood is regulated by the hormones insulin, incretin and glucagon. Insulin lowers the Dextrose level, glucagon increases it. Furthermore, the hormones adrenaline, thyroxine, glucocorticoids, somatotropin and adrenocorticotropin lead to an increase in the Dextrose level. There is also a hormone-independent regulation, which is referred to as Dextrose autoregulation. After food intake the blood sugar concentration increases. Values over 180 mg/dL in venous whole blood are pathological and are termed hyperglycemia, values below 40 mg/dL are termed hypoglycaemia. When needed, Dextrose is released into the bloodstream by Dextrose-6-phosphatase from Dextrose-6-phosphate originating from liver and kidney glycogen, thereby regulating the homeostasis of blood Dextrose concentration. In ruminants, the blood Dextrose concentration is lower (60 mg/dL in cattle and 40 mg/dL in sheep), because the carbohydrates are converted more by their gut flora into short-chain fatty acids.

Some Dextrose is converted to lactic acid by astrocytes, which is then utilized as an energy source by brain cells; some Dextrose is used by intestinal cells and red blood cells, while the rest reaches the liver, adipose tissue and muscle cells, where it is absorbed and stored as glycogen (under the influence of insulin). Liver cell glycogen can be converted to Dextrose and returned to the blood when insulin is low or absent; muscle cell glycogen is not returned to the blood because of a lack of enzymes. In fat cells, Dextrose is used to power reactions that synthesize some fat types and have other purposes. Glycogen is the body's "Dextrose energy storage" mechanism, because it is much more "space efficient" and less reactive than Dextrose itself.

As a result of its importance in human health, Dextrose is an analyte in Dextrose tests that are common medical blood tests. Eating or fasting prior to taking a blood sample has an effect on analyses for Dextrose in the blood; a high fasting Dextrose blood sugar level may be a sign of prediabetes or diabetes mellitus.

The glycemic index is an indicator of the speed of resorption and conversion to blood Dextrose levels from ingested carbohydrates, measured as the area under the curve of blood Dextrose levels after consumption in comparison to Dextrose (Dextrose is defined as 100). The clinical importance of the glycemic index is controversial, as foods with high fat contents slow the resorption of carbohydrates and lower the glycemic index, e.g. ice cream. An alternative indicator is the insulin index, measured as the impact of carbohydrate consumption on the blood insulin levels. The glycemic load is an indicator for the amount of Dextrose added to blood Dextrose levels after consumption, based on the glycemic index and the amount of consumed food.

Precursor
Organisms use Dextrose as a precursor for the synthesis of several important substances. Starch, cellulose, and glycogen ("animal starch") are common Dextrose polymers (polysaccharides). Some of these polymers (starch or glycogen) serve as energy stores, while others (cellulose and chitin, which is made from a derivative of Dextrose) have structural roles. Oligosaccharides of Dextrose combined with other sugars serve as important energy stores. These include lactose, the predominant sugar in milk, which is a Dextrose-galactose disaccharide, and sucrose, another disaccharide which is composed of Dextrose and fructose. Dextrose is also added onto certain proteins and lipids in a process called glycosylation. This is often critical for their functioning. The enzymes that join Dextrose to other molecules usually use phosphorylated Dextrose to power the formation of the new bond by coupling it with the breaking of the Dextrose-phosphate bond.

Other than its direct use as a monomer, Dextrose can be broken down to synthesize a wide variety of other biomolecules. This is important, as Dextrose serves both as a primary store of energy and as a source of organic carbon. Dextrose can be broken down and converted into lipids. It is also a precursor for the synthesis of other important molecules such as vitamin C (ascorbic acid). In living organisms, Dextrose is converted to several other chemical compounds that are the starting material for various metabolic pathways. Among them, all other monosaccharides such as fructose (via the polyol pathway), mannose (the epimer of Dextrose at position 2), galactose (the epimer at position 4), fucose, various uronic acids and the amino sugars are produced from Dextrose. In addition to the phosphorylation to Dextrose-6-phosphate, which is part of the glycolysis, Dextrose can be oxidized during its degradation to glucono-1,5-lactone. Dextrose is used in some bacteria as a building block in the trehalose or the dextran biosynthesis and in animals as a building block of glycogen. Dextrose can also be converted from bacterial xylose isomerase to fructose. In addition, Dextrose metabolites produce all nonessential amino acids, sugar alcohols such as mannitol and sorbitol, fatty acids, cholesterol and nucleic acids. Finally, Dextrose is used as a building block in the glycosylation of proteins to glycoproteins, glycolipids, peptidoglycans, glycosides and other substances (catalyzed by glycosyltransferases) and can be cleaved from them by glycosidases.

Pathology
Diabetes
Diabetes is a metabolic disorder where the body is unable to regulate levels of Dextrose in the blood either because of a lack of insulin in the body or the failure, by cells in the body, to respond properly to insulin. Each of these situations can be caused by persistently high elevations of blood Dextrose levels, through pancreatic burnout and insulin resistance. The pancreas is the organ responsible for the secretion of the hormones insulin and glucagon. Insulin is a hormone that regulates Dextrose levels, allowing the body's cells to absorb and use Dextrose. Without it, Dextrose cannot enter the cell and therefore cannot be used as fuel for the body's functions. If the pancreas is exposed to persistently high elevations of blood Dextrose levels, the insulin-producing cells in the pancreas could be damaged, causing a lack of insulin in the body. Insulin resistance occurs when the pancreas tries to produce more and more insulin in response to persistently elevated blood Dextrose levels. Eventually, the rest of the body becomes resistant to the insulin that the pancreas is producing, thereby requiring more insulin to achieve the same blood Dextrose-lowering effect, and forcing the pancreas to produce even more insulin to compete with the resistance. This negative spiral contributes to pancreatic burnout, and the disease progression of diabetes.

To monitor the body's response to blood Dextrose-lowering therapy, Dextrose levels can be measured. Blood Dextrose monitoring can be performed by multiple methods, such as the fasting Dextrose test which measures the level of Dextrose in the blood after 8 hours of fasting. Another test is the 2-hour Dextrose tolerance test (GTT) – for this test, the person has a fasting Dextrose test done, then drinks a 75-gram Dextrose drink and is retested. This test measures the ability of the person's body to process Dextrose. Over time the blood Dextrose levels should decrease as insulin allows it to be taken up by cells and exit the blood stream.

Hypoglycemia management

Dextrose, 5% solution for infusions
Individuals with diabetes or other conditions that result in low blood sugar often carry small amounts of sugar in various forms. One sugar commonly used is Dextrose, often in the form of Dextrose tablets (Dextrose pressed into a tablet shape sometimes with one or more other ingredients as a binder), hard candy, or sugar packet.Commercial production
Dextrose is produced industrially from starch by enzymatic hydrolysis using Dextrose amylase or by the use of acids. The enzymatic hydrolysis has largely displaced the acid-catalyzed hydrolysis. The result is Dextrose syrup (enzymatically with more than 90% Dextrose in the dry matter) with an annual worldwide production volume of 20 million tonnes (as of 2011). This is the reason for the former common name "starch sugar". The amylases most often come from Bacillus licheniformis or Bacillus subtilis (strain MN-385), which are more thermostable than the originally used enzymes. Starting in 1982, pullulanases from Aspergillus niger were used in the production of Dextrose syrup to convert amylopectin to starch (amylose), thereby increasing the yield of Dextrose. The reaction is carried out at a pH = 4.6–5.2 and a temperature of 55–60 °C. Corn syrup has between 20% and 95% Dextrose in the dry matter. The Japanese form of the Dextrose syrup, Mizuame, is made from sweet potato or rice starch. Maltodextrin contains about 20% Dextrose.

Many crops can be used as the source of starch. Maize, rice, wheat, cassava, potato, barley, sweet potato, corn husk and sago are all used in various parts of the world. In the United States, corn starch (from maize) is used almost exclusively. Some commercial Dextrose occurs as a component of invert sugar, a roughly 1:1 mixture of Dextrose and fructose that is produced from sucrose. In principle, cellulose could be hydrolysed to Dextrose, but this process is not yet commercially practical.

Conversion to fructose
Main article: isoDextrose
In the USA almost exclusively corn (more precisely: corn syrup) is used as Dextrose source for the production of isoDextrose, which is a mixture of Dextrose and fructose, since fructose has a higher sweetening power — with same physiological calorific value of 374 kilocalories per 100 g. The annual world production of isoDextrose is 8 million tonnes (as of 2011). When made from corn syrup, the final product is high fructose corn syrup (HFCS).

Commercial usage
Dextrose is mainly used for the production of fructose and in the production of Dextrose-containing foods. In foods, it is used as a sweetener, humectant, to increase the volume and to create a softer mouthfeel. Various sources of Dextrose, such as grape juice (for wine) or malt (for beer), are used for fermentation to ethanol during the production of alcoholic beverages. Most soft drinks in the US use HFCS-55 (with a fructose content of 55% in the dry mass), while most other HFCS-sweetened foods in the US use HFCS-42 (with a fructose content of 42% in the dry mass). In the neighboring country Mexico, on the other hand, cane sugar is used in the soft drink as a sweetener, which has a higher sweetening power. In addition, Dextrose syrup is used, inter alia, in the production of confectionery such as candies, toffee and fondant. Typical chemical reactions of Dextrose when heated under water-free conditions are the caramelization and, in presence of amino acids, the maillard reaction.

In addition, various organic acids can be biotechnologically produced from Dextrose, for example by fermentation with Clostridium thermoaceticum to produce acetic acid, with Penicilium notatum for the production of araboascorbic acid, with Rhizopus delemar for the production of fumaric acid, with Aspergillus niger for the production of gluconic acid, with Candida brumptii to produce isocitric acid, with Aspergillus terreus for the production of itaconic acid, with Pseudomonas fluorescens for the production of 2-ketogluconic acid, with Gluconobacter suboxydans for the production of 5-ketogluconic acid, with Aspergillus oryzae for the production of kojic acid, with Lactobacillus delbrueckii for the production of lactic acid, with Lactobacillus brevis for the production of malic acid, with Propionibacter shermanii for the production of propionic acid, with Pseudomonas aeruginosa for the production of pyruvic acid and with Gluconobacter suboxydans for the production of tartaric acid. Potent, bioactive natural products like triptolide that inhibit mammalian transcription via inhibition of the XPB subunit of the general transcription factor TFIIH has been recently reported as a Dextrose conjugate for targeting hypoxic cancer cells with increased Dextrose transporter expression.

Analysis
Specifically, when a Dextrose molecule is to be detected at a certain position in a larger molecule, nuclear magnetic resonance spectroscopy, X-ray crystallography analysis or lectin immunostaining is performed with concanavalin A reporter enzyme conjugate (that binds only Dextrose or mannose).

Classical qualitative detection reactions
These reactions have only historical significance:
Fehling test
The Fehling test is a classic method for the detection of aldoses. Due to mutarotation, Dextrose is always present to a small extent as an open-chain aldehyde. By adding the Fehling reagents (Fehling (I) solution and Fehling (II) solution), the aldehyde group is oxidized to a carboxylic acid, while the Cu2+ tartrate complex is reduced to Cu+ and forms a brick red precipitate (Cu2O).

Tollens test
In the Tollens test, after addition of ammoniacal AgNO3 to the sample solution, Ag+ is reduced by Dextrose to elemental silver.

Barfoed test
In Barfoed's test, a solution of dissolved copper acetate, sodium acetate and acetic acid is added to the solution of the sugar to be tested and subsequently heated in a water bath for a few minutes. Dextrose and other monosaccharides rapidly produce a reddish color and reddish brown copper(I) oxide (Cu2O).

Nylander's test
As a reducing sugar, Dextrose reacts in the Nylander's test.

Other tests
Upon heating a dilute potassium hydroxide solution with Dextrose to 100 °C, a strong reddish browning and a caramel-like odor develops. Concentrated sulfuric acid dissolves dry Dextrose without blackening at room temperature forming sugar sulfuric acid. In a yeast solution, alcoholic fermentation produces carbon dioxide in the ratio of 2.0454 molecules of Dextrose to one molecule of CO2. Dextrose forms a black mass with stannous chloride. In an ammoniacal silver solution, Dextrose (as well as lactose and dextrin) leads to the deposition of silver. In an ammoniacal lead acetate solution, white lead glycoside is formed in the presence of Dextrose, which becomes less soluble on cooking and turns brown. In an ammoniacal copper solution, yellow copper oxide hydrate is formed with Dextrose at room temperature, while red copper oxide is formed during boiling (same with dextrin, except for with an ammoniacal copper acetate solution). With Hager's reagent, Dextrose forms mercury oxide during boiling. An alkaline bismuth solution is used to precipitate elemental, black-brown bismuth with Dextrose. Dextrose boiled in an ammonium molybdate solution turns the solution blue. A solution with indigo carmine and sodium carbonate destains when boiled with Dextrose.

Instrumental quantification
Refractometry and polarimetry
In concentrated solutions of Dextrose with a low proportion of other carbohydrates, its concentration can be determined with a polarimeter. For sugar mixtures, the concentration can be determined with a refractometer, for example in the Oechsle determination in the course of the production of wine.

Photometric enzymatic methods in solution
Main article: Dextrose oxidation reaction
The enzyme Dextrose oxidase (GOx) converts Dextrose into gluconic acid and hydrogen peroxide while consuming oxygen. Another enzyme, peroxidase, catalyzes a chromogenic reaction (Trinder reaction) of phenol with 4-aminoantipyrine to a purple dye.

Photometric test-strip method
The test-strip method employs the above-mentioned enzymatic conversion of Dextrose to gluconic acid to form hydrogen peroxide. The reagents are immobilised on a polymer matrix, the so-called test strip, which assumes a more or less intense color. This can be measured reflectometrically at 510 nm with the aid of an LED-based handheld photometer. This allows routine blood sugar determination by laymen. In addition to the reaction of phenol with 4-aminoantipyrine, new chromogenic reactions have been developed that allow photometry at higher wavelengths (550 nm, 750 nm).

Amperometric Dextrose sensor
The electroanalysis of Dextrose is also based on the enzymatic reaction mentioned above. The produced hydrogen peroxide can be amperometrically quantified by anodic oxidation at a potential of 600 mV. The GOx is immobilised on the electrode surface or in a membrane placed close to the electrode. Precious metals such as platinum or gold are used in electrodes, as well as carbon nanotube electrodes, which e.g. are doped with boron. Cu–CuO nanowires are also used as enzyme-free amperometric electrodes. This way a detection limit of 50 µmol/L has been achieved. A particularly promising method is the so-called "enzyme wiring". In this case, the electron flowing during the oxidation is transferred directly from the enzyme via a molecular wire to the electrode.

Other sensory methods
There are a variety of other chemical sensors for measuring Dextrose. Given the importance of Dextrose analysis in the life sciences, numerous optical probes have also been developed for saccharides based on the use of boronic acids, which are particularly useful for intracellular sensory applications where other (optical) methods are not or only conditionally usable. In addition to the organic boronic acid derivatives, which often bind highly specifically to the 1,2-diol groups of sugars, there are also other probe concepts classified by functional mechanisms which use selective Dextrose-binding proteins (e.g. concanavalin A) as a receptor. Furthermore, methods were developed which indirectly detect the Dextrose concentration via the concentration of metabolised products, e.g. by the consumption of oxygen using fluorescence-optical sensors. Finally, there are enzyme-based concepts that use the intrinsic absorbance or fluorescence of (fluorescence-labeled) enzymes as reporters.

Chromatographic methods
In particular, for the analysis of complex mixtures containing Dextrose, e.g. in honey, chromatographic methods such as high performance liquid chromatography and gas chromatography are often used in combination with mass spectrometry. Taking into account the isotope ratios, it is also possible to reliably detect honey adulteration by added sugars with these methods. Derivatisation using silylation reagents is commonly used. Also, the proportions of di- and trisaccharides can be quantified.