Stress hyperglycemia: discussion of ways to eliminate it with the help of sugar alcohols

S.V. Kursov, V.V. Nikonov


The literature review considers the prospect of resuming active use of sugar alcohols in the practice of intensive care. The information is focused on the characteristics of the metabolism and the expected effects of sugar five-carbon alcohol xylitol. The feasibility of using xylitol solutions is justified by reducing the risk of hyperglycemia, the need for insulin admini­stration, and at the same time, reducing the risk of hypoglycemic states and preventing the development of Warburg effect. The latter is the active switching of the main cellular energy production from mitochondrial oxidative phosphorylation to glycolysis, even under conditions of sufficient oxygen supply to the body. Modern studies show that Warburg effect is critical for the progression of cancer pathology, but is also present in non-oncological diseases such as sepsis, atherosclerosis, pulmonary hypertension, heart failure, Alzheimer’s disease, and tuberculosis infection. A large number of techniques used in the practice of intensive care contribute to the activation of glycolysis processes and the formation of lactate acidosis. The danger of this mechanism of the body damage and the effect of its blocking by clinicians have not been assessed yet. In Ukraine, xylitol-based medications for intravenous infusion have been approved.


sugar alcohols; xylitol; hyperglycemia; excess insulin; hypoglycemia; insulin resistance; cellular energy production; Warburg effect; review


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