My December 14, 2021, Email to the Board of Trustees, American Medical Association (AMA) Re: Dextrose (Corn Sugar) / Conflicting Molecular Formulas

To:  Board of Trustees, American Medical Association (AMA)

Gerald.Harmon@ama-assn.org
Jack.Resneck@ama-assn.org
Susan.Bailey@ama-assn.org
Bruce.Scott@ama-assn.org
Ilsa.egbert@ama-assn.org
Bobby.Mukkamala@ama-assn.org
Sandra.Fryhofer@ama-assn.org
Russ.Kridel@ama-assn.org
Scott.Ferguson@ama-assn.org
David.Aizuss@ama-assn.org
Madelyn.Butler@ama-assn.org
Willarda.Edwards@ama-assn.org
Jesse.Ehrenfeld@ama-assn.org
Drayton.Harvey@ama-assn.org
Pratistha.Koirala@ama-assn.org
Ilse.Levin@ama-assn.org
Thomas.Madejski@ama-assn.org
Mario.Motta@ama-assn.org
Harris.Pastides@ama-assn.org
Michael.Suk@ama-assn.org
Willie.Underwood@ama-assn.org
https://www.ama-assn.org/about/board-trustees/board-trustees-members

Re:  Dextrose (Corn Sugar/D-Glucose) / Conflicting Molecular Formulas

As distinguished physicians, you are all aware that the reason corn sugar (dextrose/D-glucose)-containing IV fluids are contraindicated for administration to corn-allergic patients in the package insert is due to the fact that corn sugar is produced from cornstarch, 21CFR184.1857; and cornstarch contains allergenic corn proteins, which can prove fatal to anyone with an IgE-mediated allergy to corn.  You are also aware that clinicians can be sued for medical malpractice for administering corn sugar (dextrose/D-glucose)-containing IV fluids to corn-allergic patients in direct violation of this contraindication warning, which is equivalent to administering penicillin to a patient with an allergy to penicillin.

We believe the reason many clinicians are endangering the lives of corn-allergic patients by telling them: "You cannot be allergic to dextrose, since dextrose is naturally present in humans," is due to the American Medical Association equating corn sugar (dextrose/D-glucose) with blood sugar naturally present in all living organisms (glucose) in their "Glossary of Medical Terms."  Please provide us with your source for this claim.

"Dextrose- another name for the sugar glucose" [the source reference is not viable]
http://file.lacounty.gov/SDSInter/dmh/159358_AMAGlossaryofMedicalTerms_Ver1.0.pdf

Code of Federal Regulation, 21CFR184.1857, Corn Sugar (Dextrose/D-Glucose)

Glucose is sugar.  If it is manufactured from cornstarch, it is classified as D-glucose/dextrose vs. glucose (blood sugar) that is naturally present in all living organisms.   

Glucose: blood sugar essential for survival of all living organisms

D-Glucose: laboratory-created form of sugar produced from cornstarch (dextrose)
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1857

L-Glucose: laboratory-created form of sugar

Conflicting Molecular Formulas

We have been in contact with the FDA and the National Library of Medicine, since it is clearly apparent the incorrect molecular formula has been applied to 21CFR184.1857. The correct molecular formula should be C6H14O7, not C6H12O6.
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1857

Google search:  Sugar, corn molecular formula
MF = C6H14O7

High Fructose Corn Syrup, Molecular Formula C6H14O7

Entry Terms:

Isoglucose, C6H14O7
Maize Syrup, C6H14O7
Syrup, Maize, C6H14O7
Glucose-Fructose Syrup, C6H14O7
Glucose Fructose Syrup, C6H14O7
Syrup, Glucose-Fructose, C6H12O6
Corn Sugar, C6H12O6
Sugar, Corn, C6H14O7
High-Fructose Maize Syrup, C6H14O7
High Fructose Maize Syrup, C6H14O7
Maize Syrup, High-Fructose, C6H14O7
Syrup, High-Fructose Maize, C6H14O7
https://www.ncbi.nlm.nih.gov/mesh/68066248

Note the following conflicting molecular formulas in this list:

Glucose Fructose Syrup, C6H14O7
Syrup, Glucose-Fructose, C6H12O6
Corn Sugar, C6H12O6
Sugar, Corn, C6H14O7

 

 

I have been a full-time corn allergy advocate for nearly eight years; and in my effort to protect the lives of corn-allergic patients, I have distributed the following blog post globally (including global media).  We are requesting the immediate correction of the definition the AMA has applied to dextrose which is, in fact, corn sugar produced from allergenic cornstarch/D-glucose; and can prove fatal to anyone with an IgE-mediated allergy to corn.  

 

The American Medical Association (AMA) is intentionally endangering the lives of corn-allergic citizens, and exposing clinicians to potential liability. [Documented]
DEXTROSE IS CORN SUGAR!
https://cornallergyadvocacyresources.blogspot.com/2021/12/the-american-medical-association-ama-is.html

 

 

On behalf of corn-allergic citizens, we would appreciate your immediate attention to this critical concern.  

 

Respectfully,

 

Diane H., Corn Allergy Advocate
Corn Allergy Advocacy/Resources
https://cornallergyadvocacyresources.blogspot.com/
Email:  cornallergyinitiative@gmail.com
Twitter:  @CornAllergy911

 

Additional Reference:

My December 3, 2021, Email to the National Library of Medicine/FDA/PDR Re: Revision of PubChem CID 22814120 (Dextrose Monohydrate)
https://cornallergyadvocacyresources.blogspot.com/2021/12/my-december-3-2021-email-to-national.html

Addendum:

 

High Fructose Corn Syrup, Molecular Formula C6H14O7*

Entry Terms:

Isoglucose, C6H14O7
Maize Syrup, C6H14O7
Syrup, Maize, C6H14O7
Glucose-Fructose Syrup, C6H14O7
Glucose Fructose Syrup, C6H14O7
Syrup, Glucose-Fructose, C6H12O6
Corn Sugar, C6H12O6
Sugar, Corn, C6H14O7
High-Fructose Maize Syrup, C6H14O7
High Fructose Maize Syrup, C6H14O7
Maize Syrup, High-Fructose, C6H14O7
Syrup, High-Fructose Maize, C6H14O7
https://www.ncbi.nlm.nih.gov/mesh/68066248

 

*This is exactly how this list appeared on this website within the last month (copied directly from the website).  After I contacted the National Library of Medicine, the corresponding molecular formulas were removed; however, they are clearly noted on the corresponding PubChem documents.

 

 

Blog Post Reference:

My December 14, 2021, Email to the Board of Trustees, American Medical Association (AMA) Re: Dextrose (Corn Sugar) / Conflicting Molecular Formulas
https://cornallergyadvocacyresources.blogspot.com/2021/12/my-december-14-2021-email-to-board-of.html

 

 

 

 

The American Medical Association (AMA) is intentionally endangering the lives of corn-allergic citizens, and exposing clinicians to potential liability. [Documented]

Based on the description of their organization, it is incomprehensible that the American Medical Association would intentionally endanger patients' lives, and expose clinicians to potential liability.

"Founded in 1847, the American Medical Association (AMA) is the largest and only national association that convenes 190+ state and specialty medical societies and other critical stakeholders. Throughout history, the AMA has always followed its mission: to promote the art and science of medicine and the betterment of public health.

As the physicians’ powerful ally in patient care, the AMA delivers on this mission by representing physicians with a unified voice in courts and legislative bodies across the nation, removing obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises, and driving the future of medicine to tackle the biggest challenges in health care and training the leaders of tomorrow.

The AMA’s system of governance and policy making include the board of trustees, House of Delegates, executive vice president, councils and committees, special sections, and AMA senior leadership and staff."
https://www.ama-assn.org/about

Documented Evidence:

"Dextrose- another name for the sugar glucose" [the source reference is not viable]
http://file.lacounty.gov/SDSInter/dmh/159358_AMAGlossaryofMedicalTerms_Ver1.0.pdf

Based on testimonies from the 15K+ members in corn allergy support groups, many clinicians continue to endanger the lives of corn-allergic patients by stating that: "You cannot be allergic to dextrose, since dextrose is naturally present in our bodies."

The American Medical Association is egregiously equating corn sugar produced from cornstarch (dextrose/D-glucose) with blood sugar naturally present in all living organisms (glucose).

Corn-allergic patients will no longer tolerate this blatant deception, which intentionally endangers our lives.

Documentation:

Dextrose is the chemical name for corn sugar manufactured from cornstarch/D-glucose, 21CFR184.1857, which can prove fatal to anyone with an IgE-mediated allergy to corn.
https://cornallergyadvocacyresources.blogspot.com/2021/06/dextrose-is-corn-sugar-21cfr1841857-and.html

If "Dextrose" is referenced on the FDA’s Food Additive Status List, it refers to 21CFR184.1857.
https://www.fda.gov/food/food-additives-petitions/food-additive-status-list#ftnD

If 21CFR184.1857 is referenced, the definition is “Corn sugar” a/k/a dextrose/D-glucose

Sec. 184.1857 Corn sugar. 

(a) Corn sugar . . . commonly called D-glucose or dextrose, is the chemical [alpha]-D-glucopyranose. It occurs as the anhydrous or the monohydrate form and is produced by the complete hydrolysis of corn starch [sic] with safe and suitable acids or enzymes, followed by refinement and crystallization from the resulting hydrolysate.
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1857

...called corn sugar...the name for the sweetener dextrose...used by people who have trouble tolerating regular sugar for 30 years, the FDA says.
https://www.npr.org/sections/thesalt/2012/05/30/154009682/fda-rules-corn-syrup-cant-change-its-name-to-corn-sugar

Nutritive Sweeteners From Corn, Corn Refiners Association, 2006
https://corn.org/wp-content/uploads/2018/10/NSFC2006.pdf

The Corn Products Refining Company advertised dextrose as corn sugar in the 1940s. 

“Dextrose: All-American Corn Sugar,” Candy Professor, September 29, 2010
https://candyprofessor.wordpress.com/2010/09/29/dextrose-all-american-corn-sugar/

Corn must first be converted to corn sugar (dextrose, the common commercial name for D-glucose) . . .
https://polymerinnovationblog.com/from-corn-to-poly-lactic-acid-pla-fermentation-in-action/

Dextrose is the chemical name for corn sugar manufactured from allergenic cornstarch; therefore, dextrose cannot be "naturally present" in mammals, fruits, honey, etc.

Corn Sugar Hearings, Sixty-Ninth Congress, January 27, 1926
. . . that corn sugar is what is chemically known as dextrose . . .
https://babel.hathitrust.org/cgi/pt?id=umn.31951d03669822a&view=1up&seq=3

The American Medical Association is Exposing Clinicians to Potential Liability

Clinicians can be sued for medical malpractice for administering corn sugar (dextrose/D-glucose)-containing IV fluids to corn-allergic patients in direct violation of the contraindication warning in the package insert. Administering corn sugar (dextrose/D-glucose)-containing IV fluids to corn-allergic patients is a critical medical error equivalent to administering penicillin to a patient with an allergy to penicillin.  This medical error is subject to reporting and disclosure.

Solutions containing dextrose should be used with caution, if at all, in patients with known allergy to corn or corn products.
D-Glucopyranose monohydrate
https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/016679s104,016682s105,016692s095,019367s026lbl.pdf

Dextrose-containing solutions pose a significant risk to patients allergic to corn. Dextrose used for IV fluids is prepared by the simple hydrolysis of cornstarch.
Burbridge, Mark A. MD; Jaffe, Richard A. MD, PhD Excipients in Anesthesia Medications, Anesthesia & Analgesia: May 2019 - Volume 128 - Issue 5 - p 891-900 doi: 10.1213/ANE.0000000000003302
https://journals.lww.com/anesthesia-analgesia/Fulltext/2019/05000/Excipients_in_Anesthesia_Medications.11.aspx

College of Pharmacists of British Columbia, "Warning: corn-related allergens . . ."

Pharmacists are requested to use caution and be aware that many drugs and medications contain undisclosed potential allergens in the form of sugars, starches, and celluloses. Share the corn allergy example with prescribers, so they are aware of potential allergic reactions patients may face. This relatively unknown but potentially serious allergy highlights the need for pharmacists and other health-care professionals to be involved in ADR reporting.
http://library.bcpharmacists.org/6_Resources/6-7_ReadLinks/ReadLinks-MayJun2007.pdf

Chapter 35 Error Reporting and Disclosure
https://www.ncbi.nlm.nih.gov/books/NBK2652/

Corn-allergic patients should not be responsible for educating our clinicians in an effort to guarantee our safety.

Guidelines for reporting clinicians who administer corn sugar (dextrose/D-glucose)-containing IV fluids to corn-allergic patients in direct violation of the contraindication warning in the package insert.
https://cornallergyadvocacyresources.blogspot.com/2019/12/lactated-ringers-in-5-dextrose.html

For the safety of corn-allergic patients, we are demanding the immediate correction of the definition for dextrose (corn sugar/D-glucose) by the American Medical Association.  

 

 

Diane H., Corn Allergy Advocate
Corn Allergy Advocacy/Resources
https://cornallergyadvocacyresources.blogspot.com/
Email:  cornallergyinitiative@gmail.com
Twitter:  @CornAllergy911

 

Additional Reference:

My December 14, 2021, Email to the Board of Trustees, American Medical Association (AMA) Re: Dextrose (Corn Sugar) / Conflicting Molecular Formulas
https://cornallergyadvocacyresources.blogspot.com/2021/12/my-december-14-2021-email-to-board-of.html

Blog Post Reference: 

The American Medical Association (AMA) is intentionally endangering the lives of corn-allergic citizens, and is exposing clinicians to potential liability.  [Documented]
https://cornallergyadvocacyresources.blogspot.com/2021/12/the-american-medical-association-ama-is.html

My December 3, 2021, Email to the National Library of Medicine/FDA/PDR Re: Revision of PubChem CID 22814120 (Dextrose Monohydrate)

 Urgent Correction Required:  PubChem CID 22814120

 

Based on testimonies from the 15K+ members in corn allergy support groups, many clinicians continue to endanger the lives of corn-allergic patients by stating that: "You can't be allergic to dextrose, since dextrose is naturally present in our bodies."

Dextrose is corn sugar produced from allergenic cornstarch/D-glucose, the chemical [alpha]-D-glucopyranose. 21CFR184.1857, which can prove fatal to anyone with an IgE-mediated allergy to corn.
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1857

Source of this misinformation: 

PubChem CID 22814120

"A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state." [FALSE]
https://pubchem.ncbi.nlm.nih.gov/compound/22814120

Glucose is blood sugar naturally present in all living organisms, and is essential for their survival.  

D-glucose is a manufactured, food-derived sugar from cornstarch (dextrose), 21CFR184.1857..

 

Therefore, glucose (blood sugar) and D-glucose (corn sugar/dextrose) cannot be “biochemically identical.”  They may be mirror images of each other (enantiomers); however, like a glove, if you place your hands on top of each other, they are not identical.  Likewise, you cannot fit your right hand into a left-handed glove. 

 

Many clinicians and academics are falsely claiming that glucose is not the blood sugar that is naturally present in all living organisms. They are falsely claiming that D-glucose (corn sugar/dextrose) is naturally present in all living organisms.  In addition, they have also falsely declared that : "Dextrose is naturally present in humans."
[Documented evidence on file.]

Since corn sugar (dextrose/D-glucose) is often utilized as a glucose (blood sugar)-elevating agent, the following statement in PubChem CID 22814120 is correct.

"It is used therapeutically in fluid and nutrient replacement."
https://pubchem.ncbi.nlm.nih.gov/compound/22814120

Protect clinicians from potential malpractice lawsuits: 

Clinicians can be sued for medical malpractice for administering corn sugar (dextrose/D-glucose)-containing IV fluids to corn-allergic patients in direct violation of the contraindication warning in the package insert; therefore, your immediate attention to this issue is required. 

 

Documentation:

Lactated Ringer’s and 5% Dextrose Injection
D-Glucopyranose monohydrate
Dextrose is derived from corn.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/016679s114lbl.pdf

 

Solutions containing dextrose should be used with caution, if at all, in patients with known allergy to corn or corn products.  - Page 3
D-Glucopyranose monohydrate
https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/016679s104,016682s105,016692s095,019367s026lbl.pdf

 

Dextrose-containing solutions pose a significant risk to patients allergic to corn. Dextrose used for IV fluids is prepared by the simple hydrolysis of cornstarch.

Burbridge, Mark A. MD; Jaffe, Richard A. MD, PhD Excipients in Anesthesia Medications, Anesthesia & Analgesia: May 2019 - Volume 128 - Issue 5 - p 891-900 doi: 10.1213/ANE.0000000000003302
https://journals.lww.com/anesthesia-analgesia/Fulltext/2019/05000/Excipients_in_Anesthesia_Medications.11.aspx

 

BCPharmacists, "Warning: corn-related allergens . . ."

Pharmacists are requested to use caution and be aware that many drugs and medications contain undisclosed potential allergens in the form of sugars, starches, and celluloses. Share the corn allergy example with prescribers, so they are aware of potential allergic reactions patients may face. This relatively unknown but potentially serious allergy highlights the need for pharmacists and other health-care professionals to be involved in ADR reporting.
http://library.bcpharmacists.org/6_Resources/6-7_ReadLinks/ReadLinks-MayJun2007.pdf

 

If "Dextrose" is referenced on the FDA’s Food Additive Status List, it refers to 21CFR184.1857.
https://www.fda.gov/food/food-additives-petitions/food-additive-status-list#ftnD

If 21CFR184.1857 is referenced, the definition is “Corn sugar.”

Sec. 184.1857 Corn sugar.

(a) Corn sugar . . . commonly called D-glucose or dextrose, is the chemical [alpha]-D-glucopyranose. It occurs as the anhydrous or the monohydrate form and is produced by the complete hydrolysis of corn starch [sic] with safe and suitable acids or enzymes, followed by refinement and crystallization from the resulting hydrolysate.
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=184.1857

 

"...called corn sugar...the name for the sweetener dextrose...used by people who have trouble tolerating regular sugar for 30 years, the FDA says."
https://www.npr.org/sections/thesalt/2012/05/30/154009682/fda-rules-corn-syrup-cant-change-its-name-to-corn-sugar

 

Nutritive Sweeteners From Corn, Corn Refiners Association, 2006
https://corn.org/wp-content/uploads/2018/10/NSFC2006.pdf

 

The Corn Products Refining Company declared dextrose to be corn sugar back in the 1940s.

“Dextrose: All-American Corn Sugar,” Candy Professor, September 29, 2010
https://candyprofessor.wordpress.com/2010/09/29/dextrose-all-american-corn-sugar/

 

"Corn must first be converted to corn sugar (dextrose, the common commercial name for D-glucose) . . ." [emphasis added]
https://polymerinnovationblog.com/from-corn-to-poly-lactic-acid-pla-fermentation-in-action/

 

 

IMPORTANT FACT: 

Since dextrose is corn sugar produced from cornstarch/D-glucose, it is impossible for dextrose (corn sugar) to be naturally present in, or to be derived from, any source other than corn; e.g., dextrose (corn sugar) is not naturally present in grapes, nor can dextrose (corn sugar) be derived from grapes.

 

URGENT APPEAL:

Corn-allergic patients will no longer tolerate our clinicians telling us: "You can't be allergic to dextrose, since dextrose is naturally present in our bodies."

Therefore, we are appealing to United States government agencies to protect the lives of corn-allergic citizens by recognizing that dextrose is corn sugar produced from allergenic cornstarch (D-glucose), pursuant to Code of Federal Regulation 21CFR184.1857, which can prove fatal to anyone with an IgE-mediated allergy to corn.

 

PubChem CID 22814120 requires immediate correction to reflect the facts as presented.
https://pubchem.ncbi.nlm.nih.gov/compound/22814120

 

 

In summary, corn-allergic patients should not be required to educate our clinicians to guarantee our safety. 

 

 

 

Diane H., Corn Allergy Advocate
Corn Allergy Advocacy/Resources
https://cornallergyadvocacyresources.blogspot.com/
Email:  cornallergyinitiative@gmail.com
Twitter:  @CornAllergy911

 

Additional References:

 

Dextrose is the chemical name for corn sugar manufactured from cornstarch/D-glucose, 21CFR184.1857, which can prove fatal to anyone with an IgE-mediated allergy to corn.
https://cornallergyadvocacyresources.blogspot.com/2021/06/dextrose-is-corn-sugar-21cfr1841857-and.html

 

Guidelines for reporting clinicians who administer corn sugar (dextrose/D-glucose)-containing IV fluids to corn-allergic patients in direct violation of the contraindication warning in the package insert.
https://cornallergyadvocacyresources.blogspot.com/2019/12/lactated-ringers-in-5-dextrose.html

 

Blog Post Reference:
 

My December 3, 2021, Email to the National Library of Medicine/FDA/PDR Re: Revision of PubChem CID 22814120 (Dextrose Monohydrate)
https://cornallergyadvocacyresources.blogspot.com/2021/12/my-december-3-2021-email-to-national.html