The effect of diabetes mellitus on in-hospital hyperglycemia, length of stay and survival in patients with brain tumor receiving dexamethasone: A descriptive and comparative analysis

Clin Neurol Neurosurg. 2019 Sep:184:105450. doi: 10.1016/j.clineuro.2019.105450. Epub 2019 Jul 18.

Abstract

Objectives: To perform a comparative analysis on the impact of Type 2 Diabetes Mellitus (DM) on in-hospital hyperglycemia, length of stay (LOS) and survival of patients suffering from brain tumor who receive dexamethasone.

Patients and methods: Patients with brain tumor hospitalized in a Neurosurgery department between 2011 and 2018, were studied. Data referring to medical history, clinical characteristics and in-hospital survival was collected and analyzed. Morning plasma glucose levels (PGL) were obtained for seven consecutive days after the start of dexamethasone.

Results: Fifty-six patients were identified. Of them, 21 (37.5%) were diabetic. During dexamethasone administration, a difference in morning PGL values during different days was noted (p = 0.003). No difference in glucose levels among different glucocorticoid doses was seen. DM was associated with higher average PGL (aMPGL), calculated as the mean of morning PGL values for the last six days (p = 0.001) and with higher rates of persistent hyperglycemia (p = 0.002). The change of aMPGL from the morning PGL value of day one did not differ between the two cohorts (p = 0.729). DM neither affected LOS nor in-hospital survival (p = 0.745 & p = 0.438, respectively).

Conclusion: Although morning glucose values were higher in diabetic, compared to non-diabetic patients, their change from day one was similar between the two cohorts. LOS and in-hospital survival were not affected by DM.

Keywords: Brain tumor; Corticosteroids; Dexamethasone; Diabetes mellitus; Hyperglycemia; Outcome.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / drug effects
  • Brain Neoplasms / complications
  • Brain Neoplasms / drug therapy*
  • Dexamethasone / pharmacology*
  • Diabetes Complications
  • Diabetes Mellitus / drug therapy*
  • Female
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / drug therapy
  • Hypoglycemic Agents / pharmacology
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Dexamethasone