Multi-Patient Analysis of Steroid-Induced Hyperglycemia in Diabetic Patients Using Continuous Glucose Monitoring

Area of Science:

• Endocrinology and Metabolism
• Pharmacology and Therapeutics

Background:

• Steroid-induced hyperglycemia (SIH) is a common complication of glucocorticoid therapy.
• Previous studies lacked high-resolution glucose data, limiting understanding of SIH timing and trajectory.
• Continuous glucose monitoring (CGM) provides detailed insights into glycemic fluctuations.

Purpose of the Study:

• To characterize the temporal dynamics of SIH using CGM following steroid injections.
• To compare SIH responses across different steroid types (dexamethasone, methylprednisolone, triamcinolone).
• To investigate the influence of demographic factors (gender, age) on SIH.

Main Methods:

• Prospective, single-arm observational study of 58 adults with diabetes.
• CGM (Dexcom G7) recorded glucose every 5 minutes for up to 10 days post-injection.
• Participants received a single interventional steroid injection (dexamethasone, methylprednisolone, or triamcinolone).

Main Results:

• Glucose levels increased within ~2 hours post-injection across all steroid types.
• Dexamethasone induced consistent, rapid peaks (~220-225 mg/dL) resolving in 24-36 hours.
• Methylprednisolone showed a delayed, moderate rise (~175-185 mg/dL) with sustained elevation; triamcinolone exhibited variable responses.
• Females generally had higher, earlier peaks; younger patients showed more dynamic glucose excursions.
• Data completeness was highest within 48-72 hours post-injection.

Conclusions:

• CGM provides detailed characterization of SIH, revealing steroid-specific and demographic-modified glycemic responses.
• Dexamethasone, methylprednisolone, and triamcinolone exhibit distinct SIH patterns.
• The initial 48-72 hours post-injection represent a clinically reliable window for CGM monitoring of SIH.