Key result
Following single-dose dexamethasone administration, diabetic patients exhibited a significantly higher maximum blood glucose rise at 12 hours (188.25 mg/dl) compared to the peak at 6 hours (125.30 mg/dl) in non-diabetic patients.
Why the study?
Dexamethasone effectively prevents postoperative nausea and vomiting, but some studies have documented its association with hyperglycemia.
Does single-dose dexamethasone 8 mg IV cause a different perioperative hyperglycemic response in diabetic versus non-diabetic patients undergoing surgery under spinal anesthesia?
Observational (n=80)
No
Does single-dose dexamethasone 8 mg IV cause a different perioperative hyperglycemic response in diabetic versus non-diabetic patients undergoing surgery under spinal anesthesia?
Absolute Event Rate: 188.25% vs 125.3%
Single-dose dexamethasone for PONV prophylaxis causes a more rapid and sustained hyperglycemic response in diabetic patients compared to non-diabetics, necessitating careful postoperative blood glucose monitoring.
May warrant closer glucose monitoring in diabetics given dexamethasone; hypothesis-generating for diabetes-specific PONV strategies.
Background Dexamethasone is a potent corticosteroid when comes to effectively preventing postoperative nausea and vomiting (PONV). However, some studies have documented its association with hyperglycemia. In our study, we compared the effect of single-dose dexamethasone (8 mg) on blood glucose concentrations among diabetics and non-diabetic patients who received spinal anesthesia for elective lower abdominal and lower limb surgeries. Results We recruited 80 patients and divided them into two groups of 40 patients each. After dexamethasone administration, diabetic patients had an early peak rise of blood glucose levels at 3 h, (157.85 ± 12.19) compared to 6 h, (125.30 ± 14.95) in non-diabetics. In diabetic patients, blood glucose levels remained consistently over the baseline and maximum rise was seen at 12 h (188.25 ± 41.33), which obviated the need or administration of injection insulin. Hyperglycemia can lead to a variety of physiological derangements. Conclusions Although dexamethasone is a useful means of successful prevention and treatment of PONV, the clinician should use his clinical judgment before administering dexamethasone. Trial registration CTRI, CTRI/2020/06/025765, Registered 02 June 2020, prospectively registered, http://ctri.nic.in/Clinicaltrials/login.php .
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Joshi et al. (2023) conducted an observational in Patients undergoing elective lower abdominal and lower limb surgeries under spinal anesthesia (n=80). Type 2 Diabetes Mellitus vs. Non-diabetic patients was evaluated on Maximum rise in blood glucose levels after single-dose dexamethasone (8 mg) administration. Following single-dose dexamethasone administration, diabetic patients exhibited a significantly higher maximum blood glucose rise at 12 hours (188.25 mg/dl) compared to the peak at 6 hours (125.30 mg/dl) in non-diabetic patients.
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