CGM may reveal insights into steroid-induced hyperglycemia: Study
Researchers have found that continuous glucose monitoring (CGM) may provide detailed insights into steroid-induced hyperglycemia (SIH), showing distinct patterns based on the type of steroid and patient demographics. Dexamethasone showed a consistent glucose excursion phase, methylprednisolone had a delayed response, and triamcinolone demonstrated variable patterns. The first 48–72 hours emerged as the most reliable period for monitoring, highlighting the clinical value of CGM in detecting and managing SIH. The study was published in the Journal of Pain Research by Birthi P. and colleagues.
This prospective single-arm observational study recruited 58 adult patients with diabetes undergoing interventional pain management with a single standard-of-care steroid injection. Patients were treated with dexamethasone (n = 38), methylprednisolone (n = 15), or triamcinolone (n = 5).
Glucose levels were monitored with the Dexcom G7 CGM device, which recorded glucose every 5 minutes for up to 10 days after the injection, thereby enabling detailed analysis of glucose levels and recovery patterns. Stratified analysis was performed by steroid type, sex, and age (<64.6 years vs. ≥64.6 years).
Key findings:
The participants were 58 adults with diabetes treated with steroid injections. These were dexamethasone (38 participants), methylprednisolone (15 participants), and triamcinolone (5 participants).
• The blood glucose levels rose within 2 hours of injection for all participants.
• The blood glucose levels for dexamethasone rose to a maximum of 220–225 mg/dl and fell to baseline within 24–36 hours.
• The blood glucose levels for methylprednisolone rose to a maximum of 175–185 mg/dl with a delay and plateau for several days.
• The blood glucose levels for triamcinolone rose to a maximum of 220 mg/dl with large variability.
• The blood glucose levels were higher and earlier for females than for males.
• The blood glucose levels were more dynamic for participants under 64.6 years of age and stable for participants over 64.6 years of age.
• CGM monitors blood glucose every 5 minutes for 10 days.
• The period when blood glucose is best monitored is 48–72 hours post-injection.
Continuous glucose monitoring has identified that there are different patterns of early and steroid-specific hyperglycemia, with the first 48-72 hours considered the most important period for monitoring and managing patients with steroid-induced hyperglycemia.
Reference:
Birthi P, Pattabiraman M, Ramaswamy A, Kumar M, Agrawal A, Dua A, Nalamachu SR, Chandra S. Multi-Patient Analysis of Steroid-Induced Hyperglycemia in Diabetic Patients Using Continuous Glucose Monitoring. J Pain Res. 2026;19:1-13https://doi.org/10.2147/JPR.S569171
