Lee Seung Eun, Park Ju-Hyun, Kim Dalyong, Lee Hyun-A, Kang Yun Seong, Yoon Young Soon, Jeong Yun Jeong, Choi Han Seok, Kim Kyoung-Ah
Internal Medicine, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea.
Department of Statistics, Dongguk University, Seoul 04620, Republic of Korea.
Biomedicines. 2025 May 1;13(5):1101. doi: 10.3390/biomedicines13051101.
: Despite its high prevalence, studies on glucocorticoid-induced hyperglycemia are lacking. We examined the glucose profiles of patients with type 2 diabetes undergoing dexamethasone-containing chemotherapy using continuous glucose monitoring (CGM). We also investigated the effects of gliclazide on the management of hyperglycemia in these patients. : Seventeen patients with type 2 diabetes who received cyclic chemotherapy with dexamethasone were enrolled in this study. During the first cycle, iPro2, a blinded CGM device, was applied for 7 days. If a patient's CGM data exhibited an increase of 20% or more in the mean glucose level after dexamethasone administration, they received the second cycle, unless they had already received sulfonylurea or their chemotherapy regimen had changed. During the second cycle, the patients were treated with gliclazide as an add-on to their routine diabetic medication. : Dexamethasone treatment significantly increased glucose levels, especially in patients with a longer diabetes duration (8.4 years vs. 1.2 years, = 0.009). For the nine patients who proceeded to the second cycle, gliclazide treatment significantly ameliorated hyperglycemia. Time in range increased from 33.11% to 45.22% ( = 0.020), and time above range significantly decreased from 66.89% to 52.78% ( = 0.003). The glucose management indicators were 9.52% and 8.40% for pre- and post-gliclazide treatment, respectively. One patient visited the emergency department because of symptomatic hypoglycemia. : Chemotherapy regimens containing dexamethasone result in high blood glucose levels even after the last dexamethasone dose in patients with pre-existing diabetes. Adding gliclazide could be beneficial in managing hyperglycemia during dexamethasone-containing chemotherapy.
尽管糖皮质激素诱导的高血糖症患病率很高,但相关研究却很匮乏。我们使用连续血糖监测(CGM)来检查接受含地塞米松化疗的2型糖尿病患者的血糖情况。我们还研究了格列齐特对这些患者高血糖管理的影响。
17名接受地塞米松周期性化疗的2型糖尿病患者参与了本研究。在第一个周期中,使用iPro2(一种盲法CGM设备)进行7天的监测。如果患者的CGM数据显示在地塞米松给药后平均血糖水平升高20%或更多,他们将接受第二个周期,除非他们已经接受过磺脲类药物治疗或化疗方案已改变。在第二个周期中,患者在常规糖尿病药物治疗的基础上加用格列齐特进行治疗。
地塞米松治疗显著提高了血糖水平,尤其是糖尿病病程较长的患者(8.4年对1.2年,P = 0.009)。对于进入第二个周期的9名患者,格列齐特治疗显著改善了高血糖状况。血糖在目标范围内的时间从33.11%增加到45.22%(P = 0.020),血糖高于目标范围的时间从66.89%显著降低到52.78%(P = 0.003)。格列齐特治疗前后的血糖管理指标分别为9.52%和8.40%。有一名患者因症状性低血糖前往急诊科就诊。
含地塞米松的化疗方案即使在最后一剂地塞米松给药后,也会导致已患糖尿病患者的血糖水平升高。在含地塞米松的化疗期间加用格列齐特可能有助于控制高血糖。