Trial reportFrontiers in medicine2026
Single-dose dexamethasone increases perioperative glycemic variability in older patients with diabetes undergoing lung surgery: a continuous glucose monitoring-based randomized controlled trial.
Trial report in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
9 authors.
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Abstract
Objectives: To investigate whether a single intraoperative dose of dexamethasone alters perioperative glycemic dynamics in older patients with type 2 diabetes undergoing thoracoscopic lung resection. Glycemic dynamics were captured using continuous glucose monitoring (CGM). Methods: 72 patients aged ≥ 60 years with type 2 diabetes who underwent elective thoracoscopic lung resection were randomly assigned to receive either 8 mg of dexamethasone or placebo (0.9% saline) intravenously during anesthesia induction. The primary outcome was the maximum change in intraoperative blood glucose from preoperative baseline. Key secondary outcomes included CGM-derived glycemic variability (GV) metrics, including standard deviation (SD), coefficient of variation (CV), blood glucose instability index (GLI) and time-in-range measures, assessed throughout the perioperative period. Multivariable linear regression was performed to assess the independent effect of dexamethasone on glycemic outcomes after adjusting for relevant covariates. The accuracy of CGM was assessed using mean absolute relative difference and Bland-Altman analysis. Results: The dexamethasone group exhibited greater median (IQR) maximum intraoperative glucose change: 3.6 (3.3-4.9) mmol/L vs. 3.1 (2.6-4.0) mmol/L; Conclusion: A single 8 mg intraoperative dose of dexamethasone increases maximum intraoperative glucose change and amplifies GV in older patients with diabetes. These findings reveal a previously uncharacterized dimension of dexamethasone-induced glycemic instability in this vulnerable population and highlight the need for glycemic monitoring strategies that capture transient fluctuations potentially missed by conventional intermittent measurements. Clinical trial registration: www.chictr.org.cn, identifier [ChiCTR2300077167].
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