A newly identified clinical syndrome, dubbed glycerol intoxication syndrome (GIS), has been reported in young children who became acutely unwell after consuming slush ice drinks.
In a retrospective review published in Archives of Disease in Childhood, researchers described 21 pediatric cases across the UK and Ireland from 2009 to 2024. Nearly all children developed symptoms within an hour of ingestion. The median patient age was 3 years 6 months. Most presented with acute decreased consciousness (94%), hypoglycemia (95%), metabolic acidosis (94%), and pseudohypertriglyceridemia (89%). All tested patients showed glyceroluria on acute urine organic acid testing. Genetic testing in 14 cases ruled out underlying inherited metabolic disorders.
Slush ice drinks, widely marketed to children, often contain glycerol as a texturizing agent in sugar-free formulations. While generally recognized as safe, the study suggests that rapid or large-volume ingestion—particularly during fasting—can precipitate metabolic derangements resembling fructose-1,6-bisphosphatase or glycerol kinase deficiencies. Sixty-five percent of patients had blood glucose levels below 1.5 mmol/L. Symptoms resolved with prompt glucose administration and avoidance of further exposure, indicating a transient toxic-metabolic reaction rather than chronic disease.
Biochemical findings included metabolic acidosis (median pH 7.21), elevated lactate (median 4.3 mmol/L in 95%), and abnormal free fatty acid to 3-hydroxybutyrate ratios (elevated in 75%). Researchers hypothesize that glycerol may disrupt glucose homeostasis through effects on gluconeogenesis or osmotic pathways.
Following these findings, the UK Food Standards Agency and Food Safety Authority of Ireland advised that children under 4 should not consume glycerol-containing slush drinks, and those under 10 should limit intake. Clinicians are encouraged to consider GIS in children presenting with unexplained hypoglycemia and altered consciousness.
“Clinicians and parents should be alert to the phenomenon,” said Shona LC Brothwell of Birmingham Women’s and Children’s NHS Foundation Trust. “Public health bodies should ensure clear messaging that children under 8 years of age should avoid slush ice drinks containing glycerol.”
The study also calls for improved labeling, as glycerol content is not consistently disclosed by manufacturers. National toxicology databases, including the UK’s TOXBASE, have since updated their guidance to include management recommendations for suspected GIS. Although the precise mechanism remains unclear, the findings suggest a need for continued surveillance and investigation of glycerol’s metabolic effects in pediatric populations.
The authors declared having no competing interests.
