Dexamethasone and Diabetes: Real or Imagined Risk?

It is well known that intravenous dexamethasone given perioperatively confers a multitude of beneficial effects. Much of this relates to its potent anti-inflammatory action. As a synthetic steroid, however, there arises a concern for the possibility of increased perioperative infection. This is of particular consideration in diabetic patients who are prone to infectious complications. Jones and colleagues performed a meta-analysis on existing randomized controlled trials to ascertain the effect of short-term dexamethasone in this patient population in the operative setting. Five out of sixteen trials were included, incorporating 2,344 patients. Their analysis indicates that perioperative dexamethasone in diabetic patients does not increase the rate of surgical site infection (LOR: -0.10, 95%; 95% CI: -0.64 to 0.44). As a secondary endpoint, their results also suggest a mild reduction in composite adverse events when dexamethasone is used. A visual summary of this article is presented in this infographic, though the reader is strongly encouraged to review the cited article for a more thorough understanding of the illustrated concepts.