Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

28 April 2021: Articles

Glycemic Profile of Intravenous Dexamethasone-Induced Hyperglycemia Using Continuous Glucose Monitoring

Unusual clinical course, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis)

Fan Zhang A* , Jocelyne G. Karam A

DOI: 10.12659/AJCR.930733

Am J Case Rep 2021; 22:e930733

Table 2. Studies of glucocorticoid-induced hyperglycemia by CGM.

Author, yearSteroidStudy designPatientsResultsConclusion
Burt, 2011 []12 Prednisolone oral at least 20 mg dailyCross-sectional study60 patients with COPD including 7 patients T2DM24 h CGM showed postprandial hyperglycemia begin at 3 h, peak occurs after 5–8 h with 20% higher glucose, and wears off overnightPrednisolone predominantly cause hyperglycemia in the afternoon and evening.
Ruiz de Adana, 2015 []18 Methylprednisolone (>40 mg/d) or deflazacort (>60 mg/d) more than once dailyRandomized clinical trial53 patients with T2DM treated for respiratory disease24 h CGM showed postprandial hyperglycemia begins at3 h, peak occur after 5–8 h with 20% higher glucose, and wears off overnightInsulin glargine and NPH are equally effective in a basal-bolus insulin protocol.
Kishimoto, 2015 []17 Dexamethasone 20 mg once a week as a part of treatment for multiple myelomaCase ReportA non-insulin treated T2DM 76-year-old woman, on glimepiride, miglitol, alogliptin HA1C 7.9%4 days CGM showed postprandial hyperglycemia lasting to the next day, although received regular insulin 6 units every 6 h for 2 days after dexamethasoneDexamethasone induced postprandial hyperglycemia mainly in the afternoon, persisted the next day, and attenuated one day later
Gerards, 2016 []9 Prednisone equivalent >12.5 mg for 3–10 days with chemotherapy (median dose 50 mg, dexamethasone 8 mg)Randomized crossover study26 patients with T2DM or previous GID treated with antineoplastic chemotherapy24 h CGM showed hyperglycemia starting from 8 h and steady high more than 24 h. IMI resulted in a higher proportion of glucose values within target range than SSIOnce-daily IMI results in better glycemic control than SSI
Yata, 2017 []19 Prednisolone 25 mg to 60 mg oral once or twice dailyRetrospectivestudy11 patients with GID and CKD without pre-existing DM24 h CGM showed postprandial hyperglycemia after 3 meals, they were all improved after starting DPP-4 inhibitorsDPP-4 inhibitors can reduce glucose variability for GID
Lyall, 2018 []10 Dexamethasone 4 mg twice daily (with the first dose 20 mg) for totally 4 days, combined chemotherapy for gynecological cancerProspective study16 patients without pre-existing DM5 days CGM showed hyperglycemia throughout the 24 h period, predominantly in the afternoon and eveningAll patient developed hyperglycemia. The severity and duration are independently associated with HA1C.
Tanaka, 2018 []20 Methylprednisolone 500 mg IV daily for 3 days (the weekly cycle repeated for 3 cycles)Crossover study5 patients without pre-existing DM treated for thyroid ophthalmopathy3 days CGM showed postprandial hyperglycemia developed in 2 to 3 h and sustained for 12 hAll patient developed GID. Repaglinide has better control of postprandial hyperglycemia compared with mitiglinide
IV – intravenous; CGM – continuous glucose monitoring; COPD – chronic obstructive pulmonary disease; GID – glucocorticoid-induced diabetes; IMI – intermediate-acting insulin; SSI – short-acting sliding-scale insulin; T2DM – type 2 diabetes; CKD – chronic kidney disease; DPP-4 – dipeptidyl peptidase 4; NPH – neutral protamine hagedorn; Ref – reference.

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923