Dexamethasone, Covid-19, and increased glucose levels

This leaflet is for patients who have have increased glucose levels, due to dexamethasone treatment for Covid 19. If after reading this leaflet you have any questions or concerns, please contact your GP.

• What is Dexamethasone?

• Information for patients who do not have pre-existing diabetes

• Information for patients who do have pre-existing diabetes

• Insulin on discharge from hospital

• Monitoring your blood glucose at home

One potential side effect of Dexamethasone is higher blood glucose levels (hyperglycaemia). This is usually temporary and blood glucose levels should return to normal after you finish taking the drug. You may find your high glucose levels continue for longer, particularly if you have pre-existing factors for type 2 diabetes.

Previously undiagnosed diabetes may also be identified.

Information for patients who do not have pre-existing diabetes

Dexamethasone should not cause any long-term side effects. However, steroid-induced hyperglycaemia can last up to 36 hours after you finish taking it.

Once discharged from hospital, please contact your GP if you have any of the following symptoms of high glucose levels. They will arrange for you to have a blood test.

• Pass more urine

• Feel increasingly thirsty

• Have sudden weight loss

• Increased tiredness and lack of energy

• Fungal infection (such as genital thrush).

Information for patients who have pre-existing diabetes

Your usual diabetes medication may have been increased due to the effects of both Dexamethasone and Covid 19.

If your blood glucose levels remain higher than 15mmol/L, please contact your GP or 111.

Being discharged from hospital on insulin or having your diabetes medication changed during your hospital admission can lead to hypoglycaemia (low blood glucose levels). This often happens about 36 hours after stopping Dexamethasone.

If your blood glucose levels are lower than 4mmol/L, we may need to make changes to your medication. If this happens please contact your GP or 111.

A member of staff will give you copies of the following leaflets. This information is also available on the Diabetes UK web site.

• Sick day rules

• Hypoglycaemia Awareness

• DVLA

Covid 19 can:

• Cause severe insulin resistance and insulin deficiency. This can cause DKA (Diabeticketoacidosis) in people with type 1 diabetes and occasionally in those with type 2 diabetes. DKA is a serious complication of type 1 diabetes and less commonly type 2 diabetes. DKA happens when your blood glucose level is very high and acidic substances called ketones build up to dangerous levels in your body.

• Trigger new onset diabetes.

• Result in the need for new or increased insulin therapy, often at very high doses.

How do I monitor my blood glucose at home?

If you have been discharged from hospital with insulin, we will also give you a blood glucose meter. If you were not shown how to use it, please read the instructions in the pack. You can also use this link, and click on the picture of the meter we have given you. This web site gives you step-by-step and video guidance on how to use your meter.

Unless you have been told otherwise by your healthcare professional, continue to monitor your blood glucose twice a day. This will be before breakfast and before your evening meal. Do this until your blood glucose levels return to normal levels (between 4 and 12 mmol/L). These targets are for people with and without diabetes.

If your blood glucose levels are higher than 15mmol/L, please refer to your sick day rules leaflet and contact your GP or 111.

Further information

• Diabetes UK

  Offers general health, diet, and emotional support.

  Open: Monday to Friday, 9am to 6pm

  Helpline: 0345 1232 399

• For medical support please contact your GP or call 111.