DOI: https://doi.org/10.22141/2224-0586.4.99.2019.173932

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

S.V. Kursov, V.V. Nikonov

Abstract


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.

Keywords


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

References


Bar-Or D., Rael L.T., Madayag R.M., Banton K.L., Tanner II A., Acuna D.L., et al. Stress Hyperglycemia in Critically Ill Patients: Insight Into Possible Molecular Pathways. Frontiers in Medicine: Intensive Care Medicine & Anesthesio­logy. 2019 Mar 27. Available from: https://doi.org/10.3389/fmed.2019.00054

Gormeli K.N., Orak M., Ustundag M. Relation between Stress Hyperglycemia and Mortality in Patients with Acute Myocardial Infarction. EJMO (Eurasian Journal of Medicine & Oncology). 2018 2(3). 138-41. DOI: 10.14744/ejmo.2018.49469

Chang M.W., Huang C.Y., Liu H.T., Chen Y.C., Hsieh C.H. Stress-Induced and Diabetic Hyperglycemia Associa­ted with Higher Mortality among Intensive Care Unit Trauma Patients: Cross-Sectional Analysis of the Propensity Score-Matched Population. International Journal of Environmental Research and Public Health. 2018 May 15. 15. 992-1002. DOI: 10.3390/ijerph15050992

The NICE-SUGAR Study Investigators. Intensive Versus Conventional Glucose Control in Critically Ill Patients. New England Journal of Medicine. 2009 Mar 26. 360 (13). 1283-97. DOI: 10.1056/NEJMoa0810625

Stapleton R.D., Heyland D.K. Glycemic Control and Intensive Insulin Therapy in Critical Illness [Internet] UpToDate [Accessed July 24, 2018] Available online at: https://www.uptodate.com/contents/glycemic-control-and-intensive-insulin-thera­py-in-critical-illness

Green J.P., Berger T., Garg N., Horeczko T., Suarez A., Radeos M.S. et al. Hyperlactatemia Affects the Association of Hyperglycemia with Mortality in Nondiabetic Adults with Sepsis. Academic Emergency Medicine. 2012 Nov 20; № 19 (11). 1268-75. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/acem.12015

Berhane F., Fite A., Daboul N., Al-Janabi W., Msallaty Z., Caruso M. et al. Plasma Lactate Levels Increase during Hyperinsulinemic Euglycemic Clamp and Oral Glucose Tolerance Test. Journal of Diabetes Research. 2015 Apr 19. 2015. 102054. DOI: 10.1155/2015/102054

Liu H.Y., Yehuda-Shnaidman E., Hong T., Han J., Pi J., Liu Z. et al. Prolonged Exposure to Insulin Suppresses Mitochondrial Production in Primary Hepatocytes. Journal of Biological Chemistry. 2009 May 22. 284 (21). 14087-95. Available from: http://www.jbc.org/content/284/21/14087.full

Potter M., Newport E., Morten K.J. The Warburg Effect: 80 Years on. Biochemical Society Transactions. 2016 Oct 15. 44 (5). 1499-1505. DOI: 10.1042/BST20160094

Burns J.S., Manda G. Metabolic Pathways of the Warburg Effect in Health and Disease: Perspectives of Choice, Chain or Chance. International Journal of Molecular Sciences. 2017 Dec 19. 18 (12). 2755. DOI: 10.3390/ijms18122755

Nikonov V.V., Kursov S.V., Nudga A.N. Stressovaya giperglikemiya: vozmozhnye puti korrekcii. Medicina nevіdkladnix stanіv. 2015. 3 (66). 129-32 [in Russian].

Usenko L.V., Muslin V.P., Mosencev N.F., Mosen­cev N.N. Sposob nivelirovaniya stress-inducirovannoj giperglikemii pri tyazhyolyx kriticheskix sostoyaniyax. Medicina nevіdkladnix stanіv. 2013. 1 (48). 103-14 [in Russian].

Awuchi C.G. Sugar Alcohols: Chemistry, Production, Health Concerns and Nutritional Importance of Mannitol, Sorbitol, Xylitol, and Erythritol. International Journal of Advanced Academic Research: Sciences, Technology & Engineering. 2017 Feb. 3 (2). 31-65. Available from: https://www.researchgate.net/publication/315784468_Sugar_Alcohols_Chemistry_Production_Health_Concerns_and_Nutritional_Importance_of_Mannitol_Sorbitol_Xylitol_and_Erythritol

Ксилит — натуральная полезная альтернатива сахару. https://xylit.ru/

Packer M. Activation and Inhibition of Sodium-Hydrogen Exchanger Is a Mechanism That Links the Pathophysiology and Treatment of Diabetes Mellitus With That of Heart Failure. Circulation. 2017 Oct 17. 136 (16). 1548-59. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.030418

Apostilidou I., Prielipp R.C. Perioperative Hyperglycemia Raises Risks Inflammation/Hormones Increase Adverse Outcomes. Newsletter (the Official Journal of the Anesthesia Patient Safety Foundation). 2006 Summer 21 (1). 21-40. Available from: https://www.apsf.org/wp-content/uploads/newsletters/2006/summer/pdf/APSF200606.pdf

Furnary A.P., Wu Y., Bookin S.O. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocrine Practice. 2004 Mar-Apr. 10 (Suppl. 2). 21-33.

Corkey B.E. Hyperinsulinemia: Cause or Consequence? Diabetes. 2012 Jan. 61 (1). 4-13. Available from: http://diabetes.diabetesjournals.org/content/diabetes/61/1/4.full.pdf

Shanik M.H., Xu Y., Škrha J., Dankner R., Zick Y., Roth J. Insulin Resistance and Hyperinsulinemia. Is hyperinsulinemia the Cart or the Horse? Diabetes Care. 2008 Feb. 31 (Suppl. 2). S262-S268. Available from: https://doi.org/10.2337/dc08-s264

Dudinskaya E.N., Tkachyova O.N. Gipoglikemiya: upravlenie riskami pri saxarnom diabete. Endokrinologiya: novosti, mneniya, obuchenie. 2013 (1). 89-98 [in Russian].

Kitsios K., Tsapas A., Karagianni P. Glycemia and Cardiovascular Risk: Challenging Evidence Based Medicine. Hippokratia. 2011 Jul. 15 (3). 199-204.

Gill G.V., Woodward A., Casson I.F., Weston P.J. Cardiac Arrhythmia and Nocturnal Hypoglycaemia in Type 1 Diabetes-the «Dead in Bed» Syndrome Revisited. Diabetologia. 2009 Jan. 52 (1). 42-5. DOI: 10.1007/s00125-008-1177-7

Yun J.S., Ko S.H. Risk Factors and Adverse Outcomes of Severe Hypoglycemia in Type 2 Diabetes Mellitus. Diabetes & Metabolism Journal. 2016 Dec. 40 (6). 423-32. DOI: 10.4093/dmj.2016.40.6.423

Nikonov V.V., Kursov S.V., Beleckij A.V. Dikarbonilnyj stress: gipoteza kletochnogo povrezhdeniya v usloviyax gipoksii. puskovoj mexanizm razvitiya multiorgannoj disfunkcii. Medicina nevіdkladnix stanіv. 2017. 4 (83). 78-85 [in Russian].

American Diabetes Association. Nutrition Recommendations and Interventions for Diabetes. A position statement of the American Diabetes Association. Diabetes Care. 2007 Jan. 30 (Suppl. 1). S48-S65. Available from: https://doi.org/10.2337/dc07-S048

Боднар П.Н., Михальчишин Г.П. Особенности терапии сахарного диабета II типа. https://m-l.com.ua/?aid = 498images/page_15.gif.

Mäkinen K.K. Can the Pentitol-Hexitol Theory Explain the Clinical Observations Made with Xylitol? Medical Hypotheses. 2000 54 (4). 603-13.

Metzler D.E., Metzler C.M. Biochemistry. The Chemical Reactions of Living Cells. The Second Edition. Chapter 4: Sugars, Polysaccharides, and Glycoproteins. Chapter 20: Some Pathways of Carbohydrate Metabolism. San Diego. Academic Press, 2001. 937 p.

U.S. National Library of Medicine. National Center for Biotechnology Information. Xylitol (Compound Summary) [Internet] PubChem [Modify: 2019-05-25; cited May 30, 2019]. Avai­lable from: https://pubchem.ncbi.nlm.nih.gov/compound/Xylitol

Gunnars K. Xylitol: Everything You Need to Know [Internet] Healthline [written Oct 04, 2018; cited May 31, 2019] Avai­lable from: https://www.healthline.com/nutrition/xylitol-101

Livesey G. Health Potential of Polyols as Sugar Repla­cers, with Emphasis on Low Glycaemic Properties. Nutrition Research Reviews. 2003 Dec. 16 (2).163-91.

Wiebe N., Padwal R., Field C., Marks S., Jacobs R., Tonelli M. A Systematic Review on the Effect of Sweeteners on Glycemic Response and Clinically Relevant Outcomes. BMC Medicine. 2011 Nov 17. 9. 123. DOI: 10.1186/1741-7015-9-123

Islam M.S., Indrajit M. Effects of Xylitol on Blood Glucose, Glucose Tolerance, Serum Insulin and Lipid Profile in a Type 2 Diabetes Model of Rats. Annals of Nutrition and Metabolism. 2012. 61 (1). 57-64. DOI: 10.1159/000338440

Islam M.S. Effects of Xylitol as a Sugar Substitute on Diabetes-related Parameters in Nondiabetic Rats. Journal of Medicinal Food. 2011 May. 14 (5). 505-11. DOI: 10.1089/jmf.2010.0015

Jenkins D.J., Wolever T.M., Taylor R.H., Barker H., Fielden H., Baldwin J.M. et al. Glycemic Index of Foods: a Physiological Basis for Carbohydrate Exchange. The American Journal of Clinical Nutrition. 1981 Mar 01. 34 (3). 362-6. Available from: https://doi.org/10.1093/ajcn/34.3.362

Chen Z., Liu M., Li L., Chen L. Involvement of the Warburg Effect in Non-tumor Diseases Processes. Journal of Cell Physiology. 2018 Apr. 233 (4). 2839-49. DOI: 10.1002/jcp.25998.

Bar-Or D., Carrick M., Tanner A., Lieser M.J., Rael L.T., Brody E. Overcoming the Warburg Effect: Is It the Key to Survival in Sepsis? Journal of Critical Care. 2018 Feb. 43. 197-201.

Natesan V. Adrenergic Blockade Inhibits Bacterial Quorum Sensing and Reverses Warburg Effect in Septic Shock. British Journal of Anaesthesia. 2018 Feb. 120 (2). 412-3. DOI: 10.1016/j.bja.2017.12.010

Brault C., Zerbib Y., Delette C., Marc J., Gruson B., Marolleau J.P. et al. The Warburg Effect as a Type B Lactic Acidosis in a Patient with Acute Myeloid Leukemia: A Diagnostic Challenge for Clinicians. Frontiers in Oncology. 2018 Jun 20. 8. 232. DOI: 10.3389/fonc.2018.00232

Trachootham D., Chingsuwanrote P., Yoosadiang P., Mekkriangkrai D., Ratchawong T., Buraphacheep N. et al. Partial Substitution of Glucose with Xylitol Suppressed the Glycolysis and Selectively Inhibited the Proliferation of Oral Cancer Cells. Nutrition and Cancer. 2017 Jul 18. 69 (6). 862-72. Available from: https://www.tandfonline.com/doi/abs/10.1080/01635581. 2017.1339097?scroll = top&needAccess = true&journalCode = hnuc20

Чепкий Л.П. Применение нового инфузионного препарата Ксилат в интенсивной терапии. https://m-l.com.ua/?aid = 483

Ксилит и другие сахарозаменители при сахарном диабете. http://diabetanety.com/diabet/ksilit-i-sakharozameniteli

Alfarouk K.O., Verduzco D., Rauch C., Muddathir A.K., Adil H.H. et al. Glycolysis, tumor metabolism, cancer growth and dissemination. A new pH-based etiopathogenic perspective and therapeutic approach to an old cancer question. Oncoscience. 2014 Dec 18. 1 (12). 777-802.

Alfarouk Khalid O., Muddathir Abdel Khalig, Shayoub Mohammed E.A. (20 January 2011). Tumor Acidity as Evolutionary Spite. Cancers. 3 (4). 408-414. DOI: 10.3390/cancers3010408

Gatenby R.A., Gillies R.J. Why do cancers have high aerobic glycolysis? Nature Reviews Cancer. 2004. 4 (11). 891-9. DOI: 10.1038/nrc1478. PMID 15516961

Kim J.W., Dang C.V. Cancer's molecular sweet tooth and the Warburg effect. Cancer Res. 2006. 66 (18). 8927-8930. DOI: 10.1158/0008-5472.CAN-06-1501. PMID 16982728




Copyright (c) 2019 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2019

 

   Seo анализ сайта