Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus

Perioperative intravenous (IV) dexamethasone is administered prophylactically for post operative nausea and vomiting. However, its glucocorticoid property which raises blood glucose is of concern, especially among diabetic patients. The surgical stress response also contributes to increased perioper...

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Main Authors:	Elliza R, Nadia Md Nor, Azlina M, Yeoh CN, Maryam B, Hanita O
Format:	Article
Language:	English
Published:	Pusat Perubatan Universiti Kebangsaan Malaysia 2018
Online Access:	http://journalarticle.ukm.my/12561/ http://journalarticle.ukm.my/12561/ http://journalarticle.ukm.my/12561/1/3.eliza_r_et_al.pdf

id	ukm-12561
recordtype	eprints
spelling	ukm-125612019-02-14T21:40:28Z http://journalarticle.ukm.my/12561/ Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus Elliza R, Nadia Md Nor, Azlina M, Yeoh CN, Maryam B, Hanita O, Perioperative intravenous (IV) dexamethasone is administered prophylactically for post operative nausea and vomiting. However, its glucocorticoid property which raises blood glucose is of concern, especially among diabetic patients. The surgical stress response also contributes to increased perioperative blood glucose. Prior studies showed higher glucose levels with dexamethasone 8 mg compared to 4 mg, hence we studied the effect of the lower dose amongst diabetic patients. This prospective, single blinded, randomised study recruited forty-six type 2 diabetes mellitus patients planned for surgery under general anaesthesia. They received IV dexamethasone 4 mg or saline (placebo) after induction of anaesthesia. Capillary blood glucose levels were recorded preoperatively, and subsequently at recovery (T0), and at 6, 12, 18 and 24 (T6, T12, T18, T24) hours post-operatively. Median glucose levels were higher at 9.0 [10.5-7.7] mmol/l in the dexamethasone group, versus 7.4 [9.2-5.9] mmol/l in the placebo group at T0, p = 0.022. Similarly at T6, the dexamethasone group recorded higher glucose levels of 11.2 [15.0-9.3] mmol/l, versus 7.7 [9.0-6.2] mmol/l in the placebo group, p = 0.001. This corresponded to a significant difference between the groups, in the change of glucose levels from baseline values, p = 0.042. Subsequent readings at T12, T18, and T24 were comparable between the groups. In conclusion, IV dexamethasone 4 mg in type 2 diabetic patients, resulted in higher glucose levels immediately postoperative and 6 hours later. The change in blood glucose from baseline levels was significant between the groups at 6 hours postoperatively. Glucose levels however remained within acceptable range of approved guidelines in both groups at all recorded intervals. Pusat Perubatan Universiti Kebangsaan Malaysia 2018 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/12561/1/3.eliza_r_et_al.pdf Elliza R, and Nadia Md Nor, and Azlina M, and Yeoh CN, and Maryam B, and Hanita O, (2018) Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus. Journal of Surgical Academia, 8 (2). pp. 11-16. ISSN 2231-7481 http://jsurgacad.com/toc
repository_type	Digital Repository
institution_category	Local University
institution	Universiti Kebangasaan Malaysia
building	UKM Institutional Repository
collection	Online Access
language	English
description	Perioperative intravenous (IV) dexamethasone is administered prophylactically for post operative nausea and vomiting. However, its glucocorticoid property which raises blood glucose is of concern, especially among diabetic patients. The surgical stress response also contributes to increased perioperative blood glucose. Prior studies showed higher glucose levels with dexamethasone 8 mg compared to 4 mg, hence we studied the effect of the lower dose amongst diabetic patients. This prospective, single blinded, randomised study recruited forty-six type 2 diabetes mellitus patients planned for surgery under general anaesthesia. They received IV dexamethasone 4 mg or saline (placebo) after induction of anaesthesia. Capillary blood glucose levels were recorded preoperatively, and subsequently at recovery (T0), and at 6, 12, 18 and 24 (T6, T12, T18, T24) hours post-operatively. Median glucose levels were higher at 9.0 [10.5-7.7] mmol/l in the dexamethasone group, versus 7.4 [9.2-5.9] mmol/l in the placebo group at T0, p = 0.022. Similarly at T6, the dexamethasone group recorded higher glucose levels of 11.2 [15.0-9.3] mmol/l, versus 7.7 [9.0-6.2] mmol/l in the placebo group, p = 0.001. This corresponded to a significant difference between the groups, in the change of glucose levels from baseline values, p = 0.042. Subsequent readings at T12, T18, and T24 were comparable between the groups. In conclusion, IV dexamethasone 4 mg in type 2 diabetic patients, resulted in higher glucose levels immediately postoperative and 6 hours later. The change in blood glucose from baseline levels was significant between the groups at 6 hours postoperatively. Glucose levels however remained within acceptable range of approved guidelines in both groups at all recorded intervals.
format	Article
author	Elliza R, Nadia Md Nor, Azlina M, Yeoh CN, Maryam B, Hanita O,
spellingShingle	Elliza R, Nadia Md Nor, Azlina M, Yeoh CN, Maryam B, Hanita O, Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus
author_facet	Elliza R, Nadia Md Nor, Azlina M, Yeoh CN, Maryam B, Hanita O,
author_sort	Elliza R,
title	Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus
title_short	Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus
title_full	Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus
title_fullStr	Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus
title_full_unstemmed	Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus
title_sort	dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus
publisher	Pusat Perubatan Universiti Kebangsaan Malaysia
publishDate	2018
url	http://journalarticle.ukm.my/12561/ http://journalarticle.ukm.my/12561/ http://journalarticle.ukm.my/12561/1/3.eliza_r_et_al.pdf
first_indexed	2023-09-18T20:02:53Z
last_indexed	2023-09-18T20:02:53Z
_version_	1777406966185852928

Dexamethasone and postoperative capillary glucose levels in type 2 diabetes mellitus

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