# Optimizing Recovery in Elderly Patients: Anabolic Benefits of Glucose Supplementation during the Rehydration Period

## TL;DR

Adding glucose to fluids given to elderly hospitalized patients may shift their metabolism toward building up nutrients, but it can also increase the risk of refeeding syndrome.

## Contribution

The study introduces a novel approach of supplementing glucose during rehydration in elderly patients to induce an anabolic shift.

## Key findings

- Patients receiving glucose-enriched fluids had a significantly higher risk of refeeding syndrome symptoms like low phosphate, potassium, and magnesium.
- Electrolyte drops were likely due to cellular uptake, as no differences were found in urine levels.
- There was no significant difference in short-term or one-year mortality between the groups.

## Abstract

Background: Since many acutely admitted older adults display signs of dehydration, treatment using balanced crystalloids is an important part of medical care. Additionally, many of these patients suffer from chronic malnutrition. We speculated that the early addition of glucose might ameliorate the hospital-related drop of caloric intake and modify their catabolic status. Methods: We included patients 78 years and older, admitted acutely for non-traumatic illnesses. The patients were randomized into either receiving balanced crystalloid (PlasmaLyte; group P) or balanced crystalloid enriched with 100 g of glucose per liter (group G). The information about fluid balance and levels of minerals were collected longitudinally. Results: In the G group, a significantly higher proportion of patients developed signs of refeeding syndrome, i.e., drops in phosphates, potassium and/or magnesium when compared to group P (83.3 vs. 16.7%, p < 0.01). The drop in phosphate levels was the most pronounced. The urinalysis showed no differences in the levels of these minerals in the urine, suggesting their uptake into the cells. There were no differences in the in-hospital mortality or in the 1-year mortality. Conclusion: The short-term administration of balanced crystalloids with glucose induced an anabolic shift of electrolytes in acutely admitted older adults.