Abstract #1153925: Dexamethasone Use and Insulin Requirements in Coronavirus Disease-19 (COVID-19) Infection

https://doi.org/10.1016/j.eprac.2022.03.063Get rights and content

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Objective

The objective of this study was to evaluate the effects of dexamethasone on blood glucose (BG) and insulin requirements in COVID-19 infection.

Methods

This was a retrospective chart review of patients 18 years and older who were admitted with COVID-19 infection to an academic tertiary care hospital in New York in November 2020. Expedited approval was granted by our health system’s Institutional Review Board. Patients were included if they received at least one dose of dexamethasone 6 mG. Patients were excluded if they were on chronic steroids at home for any indication. Patient demographic information, BG, insulin doses, and outcomes were

Results

Seventy-five patients were included in the analysis. The mean age was 62.1 (± 14.9) years and 32% of patients had a diagnosis of type 2 diabetes. Fifty-five percent of patients experienced hyperglycemia (defined as BG > 180 mG/dL) and of those, 44% did not have a history of diabetes. The average number of days to hyperglycemia was 1.6 (± 2.4) and the average number of days to insulin adjustment was 3.6 (± 3.2). One-hundred percent of patients with a hemoglobin A1c (HbA1c) ≥ 7% and 72% of

Discussion/Conclusion

Dexamethasone treatment for COVID-19 frequently manifests hyperglycemia. All patients are susceptible, but those with higher HbA1c experience increased rates of hyperglycemia and require higher insulin doses. Once dexamethasone is discontinued, it is important to titrate insulin appropriately to prevent hypoglycemia. Future studies in this area may help streamline hospital insulin dosing protocols for COVID-19 infection.

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