Beschreibung
Dexamethasone causes dose-dependent hyperglycaemia by inducing insulin resistance and increasing hepatic glucose output, substantially increasing insulin requirements in diabetic patients.
Mechanismus
Glucocorticoids activate gluconeogenic enzymes in the liver, suppress GLUT4 translocation in peripheral tissues, and impair insulin receptor signalling, resulting in peripheral insulin resistance and postprandial hyperglycaemia.
Klinische Bedeutung
Steroid-induced hyperglycaemia is well-documented; insulin requirements can increase by 30–100% depending on dexamethasone dose, particularly affecting afternoon and evening glucose levels.
Maßnahmen
Increase insulin glargine dose (and consider adding short-acting insulin) when dexamethasone is initiated; monitor blood glucose at least 4 times daily; reduce insulin dose when dexamethasone is tapered to avoid rebound hypoglycaemia.
Medizinischer Haftungsausschluss
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.