Short-Term Effects of Corticosteroid Therapy on Blood Glucose Fluctuations in Hospitalized Patients

https://doi.org/10.5281/zenodo.20087016

Abstract

Background: Corticosteroids are extensively used among hospitalized patients due to their anti-inflammatory and immunosuppressive properties, yet have been demonstrated to cause hyperglycemia. Fluctuations in short-term glucose during steroid therapy may enhance morbidity, especially among patients with pre-existing diabetes.

Objective: To assess the immediate impacts of corticosteroid treatment on blood glucose variability in hospitalized clients.

Methods: The length of this prospective observational study was six months from January 2025 to July 2025. Consecutive sampling was used to enroll 216 patients who were undergoing systemic corticosteroids ≥48 hours. Capillary glucose levels were assessed both at fasting and post-prandial rates for five days following the initiation of corticosteroids. Standard deviation (SD) and mean amplitude of glycemic excursions (MAGE) were used to measure glycemic variability. ANOVA, independent t-tests, Mann-Whitney U, and chi-square tests were used to compare diabetic and non-diabetic patients. The significance level was set to a p-value less than 0.05.

Results: The level of blood glucose rose markedly in both control and diabetic patients under corticosteroid treatment (p<0.001). The patients with diabetes had an increased glycemic variability (SD: 20.3 ±5.6 vs 12.8 ± 4.2 mg/dL, p<0.001; MAGE: 45.6 ±10.2 vs 28.7 ±7.4 mg/dL, p<0.001) and a higher frequency of hyperglycemic episodes (p<0.001).

Conclusion: In hospitalized patients, corticosteroid therapy in the short-term causes severe glucose variations, especially in the post-prandial period and in diabetic patients. The metabolic complications of corticosteroid therapy should be reduced by early glucose monitoring and individualized glycemic management.