Thanks for this interesting question. Here are my thoughts:
1. We cannot deprive Diabetic patients from Dextrose. Every patient should receive at least 120g of dextrose that is crucial for brain function and renal medulla homeostasis.
2. It is recommend to hold all sources of Sugar i.e. LVP, minibags, PO, EN in case of severe/acute glucose intolerance until insulin therapy is initiated and glucose level is controlled. This happens during Acute Phase response in metabolically stressed patients
3. If the patient is receiving LVP containing D5W, calculate sugar content per day, insulin need per day and use your clinical judgement if meds are to be diluted with D5W or NS
4. Normal intake for sugar in diabetic patients is 200g/day while not exceeding 100 units of exogenous insulin per day
In conclusion, it is not wrong to use D5W in minibags for diabetic patients assuming we take above factors in consideration!
Hope this helps
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