Covid walata Dexamethasone gatha aya innawada? Blood sugar bahinna kochara kal giyada?
Dexamethasone has a long half-life. A 6 - 12 mg dose could have a half-life of 36 - 72 hrs. Corticosteroid can cause hyperglycaemia, both in those with pre-existing diabetes and in those at risk of diabetes.
COVID-19 disease itself also induces hyperglycaemia in many patients. COVID-19 infection coupled with corticosteroid treatments are causing an increase in hyperglycaemia and use of insulin.
This phenomenon is due to a metabolic response of the pancreatic beta cells to hyperglycemia, resulting in reduced peripheral sensitivity to insulin and also due to glucocorticoids being able to alter the insulin production by reducing the effect of incretins. The exact mechanism is not really known.
The effects vary from one patient to another, usually it takes about 3 days to sometimes three weeks... Unpredictable, but mostly short term. Therefore, other steroid-related diabetes medications on cessation of corticosteroids is recommended in most cases, except for those with pre-existing suboptimal glycaemic control (HbA1c ≥68mmol/mol). The doctor will advise if there's any concern.