COVID-19 and dexamethasone-induced hyperglycaemia: workload implications for diabetes inpatient teams.

Abstract

The RECOVERY trial showed that mortality in patients requiring supplementary oxygen or ventilation for COVID-19 is reduced by administration of dexamethasone 6 mg daily for up to 10 days [1]. This welcome finding led to an increased frequency of dexamethasone use at our district general hospital. However, high-dose glucocorticoid exposure is a well-recognised cause of hyperglycaemia, particularly in the presence of diabetes [2-7]. Furthermore, glucocorticoid-induced hyperglycaemia is associated with an increased risk of mortality, infections, and cardiovascular events [8]. Guidelines have been developed to address these risks, both in the general inpatient setting and specifically in the context of COVID-19 [9-10].