Hyperglycemic consequences of corticosteroid premedication in an outpatient population

The purpose of our study was to assess the glycemic risk of a 13-hour corticosteroid premedication regimen in outpatients.

Clinical documentation for 216 outpatients premedicated with a 13-hour corticosteroid regimen before an abdominopelvic CT examination between February 20, 2009, and September 15, 2009, was reviewed. Periprocedural serum glucose obtained between 2 hours before and 72 hours after CT was compared with baseline serum glucose.

Serum glucose was available for 46 premedication episodes in 43 patients (10 with type 2 diabetes and 33 without diabetes). Mean baseline nonfasting serum glucose was 177 mg/dL (range, 110-290 mg/dL) for diabetic patients and 117 mg/dL (range, 85-190 mg/dL) for those without diabetes. The mean rise in serum glucose was 58 mg/dL at +/-2-24 hours, 10 mg/dL at 25-48 hours, and -2 mg/dL at 49-72 hours. Mean maximal change in serum glucose was greater (p = 0.02) in diabetic patients (mean, 87 mg/dL; range, -134 to 295) than in those without diabetes (mean, 27 mg/dL; range, -35 to 172 mg/dL). No patient developed a hyperglycemia-related hospital admission or complication. One diabetic patient required a temporary increase in daily insulin dose.

An outpatient 13-hour corticosteroid premedication regimen is associated with a short-term rise in serum glucose that is greater in type 2 diabetic patients but unlikely to result in a clinically significant outcome.