Förster H
Infusionsther Klin Ernahr. 1987 Jun;14(3):98-109.
The glucose substitutes (fructose, sorbitol, xylitol) have significant metabolic advantages in stress situations as compared to glucose. Side-effects are usually not to be expected if indications and dosage are carefully determined. The only contraindication for fructose and for sorbitol is hereditary fructose intolerance. However, this metabolic disease should be known to physicians who are involved in parenteral nutrition. Fructose intolerance might also be diagnosed by the metabolic alterations caused by fructose or by sorbitol administration in such patients. It was shown repeatedly during the last few decades that glucose formed in the liver during metabolism of glucose substitutes and delivered to the circulation is obviously metabolized without an increase in blood glucose concentration and without additional requirement of insulin. No explanation for this amazing, long-observed metabolic effect is known to date. These reproducible results should stimulate new investigations. Such effects should not be rejected or questioned because they do not fit into the hypotheses.
与葡萄糖相比，葡萄糖替代物（果糖、山梨醇、木糖醇）在应激情况下具有显著的代谢优势。如果仔细确定适应症和剂量，通常不会出现副作用。果糖和山梨醇的唯一禁忌症是遗传性果糖不耐受。然而，参与肠外营养的医生应该了解这种代谢疾病。果糖不耐受也可能通过此类患者中果糖或山梨醇给药引起的代谢改变来诊断。在过去几十年中反复表明，葡萄糖替代物代谢过程中在肝脏中形成并输送到循环系统的葡萄糖显然在不增加血糖浓度且无需额外胰岛素的情况下被代谢。迄今为止，对于这种惊人的、长期观察到的代谢效应尚无解释。这些可重复的结果应该激发新的研究。不应因为这些效应不符合假设就予以否定或质疑。
