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