Patients with which condition need intravenous thiamine before the infusion of fluids with glucose?

Patients with alcoholism are at risk for thiamine deficiency because chronic alcohol consumption can lead to malabsorption of nutrients, including thiamine (Vitamin B1). Thiamine plays a critical role in carbohydrate metabolism and is essential for the functioning of enzymes involved in glucose metabolism.

When a person with a thiamine deficiency is given intravenous glucose without prior thiamine supplementation, they are at risk for developing Wernicke's encephalopathy, a neurologic condition characterized by confusion, ophthalmoplegia, and ataxia. This occurs due to an increased demand for thiamine that is not met, as the infusion of glucose promotes metabolism and increases thiamine utilization.

Immediate thiamine administration prior to or with intravenous glucose is essential in these patients to prevent neurologic complications. Knowing this risk emphasizes the importance of assessing thiamine levels in individuals with a history of chronic alcohol use before administering glucose-containing fluids.