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Perioperative management for diabetic surgery: Effect of dexamethasone on blood glucose control - a systematic review and meta-analysis |
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| รหัสดีโอไอ | |
| Creator | Xuebing Wang |
| Title | Perioperative management for diabetic surgery: Effect of dexamethasone on blood glucose control - a systematic review and meta-analysis |
| Contributor | Wenqiu Feng, Xueling Diao, Xiaojie Su |
| Publisher | Maejo University |
| Publication Year | 2567 |
| Journal Title | Maejo International Journal of Science and Technology |
| Journal Vol. | 18 |
| Journal No. | 3 |
| Page no. | 290 |
| Keyword | dexamethasone, diabetes, hyperglycemia, perioperative care, postoperative nausea and vomiting |
| Website title | Maejo International Journal of Science and Technology |
| ISSN | 1905-7873 |
| Abstract | Dexamethasone (DEX) is widely used for preventing postoperative nausea and vomiting (PONV), but its tendency to induce hyperglycemia in diabetic surgical patients is a concern. This systematic review examines the impact of DEX on perioperative blood glucose control in diabetic patients undergoing surgery. We comprehensively searched databases for randomised controlled trials published between 2019 and 2024. Analysis of six key studies involving 18,217 patients revealed significant increases in blood glucose levels following DEX administration. In diabetic patients maximum glucose levels reached 226.8 [185.4-329.4] mg/dL with 4 mg DEX and 244.8 [201.6-361.8] mg/dL with 8 mg DEX. Non-diabetic patients experienced milder elevations. The risk of hyperglycemia (>180 mg/dL) increased in DEX-treated patients, with one study reporting 10.7% of DEX patients exceeding this threshold. The hyperglycemic effect was most pronounced within 2-24 hr of post-administration and showed a significant interaction with preoperative HbA1c levels. Our findings emphasise the need for vigilant blood glucose monitoring and individualised management strategies when using DEX in diabetic patients. Future research should focus on developing tailored protocols that optimise PONV prevention while minimising hyperglycemic risk. |
