Multi-Patient Analysis of Steroid-Induced Hyperglycemia in Diabetic Patients Using Continuous Glucose Monitoring
Pravardhan Birthia,b, Mahesh Pattabiramanb, Akila Ramaswamyb, Mrityunjay Kumara, Akshay Agrawalc, Anterpreet Duad, Srinivas Nalamanchue, Surabhi Chandraef, Ph.D.
a.Grand Island Pain Relief Center, Grand Island, NE
b.Tricity Research Center, Grand Island, NE
c.Bryan Health, Grand Island, NE
d.Augusta University, Augusta, NE
e.Analgesic Clinic Research, Overland Park, KS
f.University of Nebraska Kearney, Kearney, NE
Background:
•Steroid therapy can cause hidden spikes in blood sugar — traditional monitoring often misses them.
•Continuous glucose monitoring (CGM) reveals real-time patterns of steroid-induced hyperglycemia, uncovering when and how glucose levels truly fluctuate.
Objective:
•To characterize the glycemic response after a single steroid injection using CGM data and assess differences by:
•steroid type
•gender
•age
Methods:
•Observational study of 58 diabetic patients (mean age 64.6 years) receiving a single steroid injection for pain relief.
•Patients grouped by steroid type (dexamethasone, methylprednisolone, triamcinolone), gender, and age (<64.6 vs. ≥64.6 years).
•Continuous glucose monitoring (CGM) recorded glucose every 5 minutes for up to 10 days post-injection.
Results:
•All steroid types caused a rapid glucose rise within 2 hours, with dexamethasone showing the highest and most consistent peak (~220–225 mg/dL), followed by a decline to ~150 mg/dL at 24–36 hours.
•Methylprednisolone induced a moderate, delayed increase, while triamcinolone showed variable, inconsistent glucose patterns despite similar peak levels (~220 mg/dL).
•Females showed higher peaks and faster recovery, and younger patients (<64.6 years) had more dynamic fluctuations, whereas older individuals displayed flatter, steadier glucose profiles
Conclusion:
•This study provides the most detailed CGM-based insight into steroid-induced hyperglycemia in a real-world setting.
•Distinct glycemic patterns were identified — dexamethasone produced a predictable, rapid glucose excursion, while methylprednisolone caused a delayed, gradual rise.
•Dexamethasone’s consistent profile suggests potential for anticipatory glycemic management during steroid therapy.
Limitation:
•Small triamcinolone sample size limits the reliability and comparability of its glycemic response profile.
•Reduced CGM data after day 8 introduces variability and restricts interpretation of long-term glucose trends.
Acknowledgments:
TCRC (for compiling and communicating manuscript),
GIPRC staff (for compiling data and helping patients) and Rashmi Rikhi (for helping with the poster design)
References:
•Coutinho & Chapman, 2011 – Glucocorticoids: anti-inflammatory & immunosuppressive
•Strehl et al., 2019 – Glucocorticoids: versatile immune modulators
•Van der V., 1998 – Glucocorticoids: mechanisms & anti-inflammatory effects
