Utilization of Glucose, Fructose,

the comparative utilization of infused glucose, fructose, and invert sugar have appeared in the recent surgical and biochemical literature, the results of these studies are still equivocal. Certain investigations have indicated that fructose and invert sugar are superior to glucose for parenteral feeding purposes; others have suggested the reverse. In previous studies Weichselbaum,1 Elman and Lund, using infusion rates of 0.6 to 2 gm. per kilogram per hour, reported that after fructose the urine contained little sugar as compared with glucose. The diuretic effect was less pronounced with fructose. Lawton and Curreri and Gale found that a 10% solution of invert sugar can be given more rapidly and is more completely utilized than glucose.2 They also noted a lessened diuretic effect with invert sugar. In this study 1 liter of solution was infused at a rate of 1.5 gm. per kilogram body weight per hour for only 30 minutes; it was found that more fructose than glucose was excreted both in normal persons and in patients with liver disease.3 J. L. Smith and co-workers concluded that invert sugar and fructose are not as well utilized as glucose when given at a rate of 1 liter of 10% solution in two hours' time.* Finally, M. Miller and his associates found that similar amounts (less than 10%) of glucose and fructose appear in the urine after infusions of these sugars at the rate of 1 gm. per kilogram per hour.5 Such apparently contradictory reports can be partially resolved if one appreciates the fact that the experimental conditions under which these various studies were carried out varied considerably with respect to rate, duration, and amount of infusion, as well as to the state of nutrition and hydration of the patients. Moreover, in very few studies did