Glucose Variability in Cancer Patients Receiving Dexamethasone

Dexamethasone is a steroid commonly used for the prevention of chemotherapy-induced nausea
and vomiting (CINV). While effective, high dose dexamethasone is associated with numerous
side effects, even when used for a short duration. One such effect is elevated blood glucose,
or hyperglycemia. Current literature suggests increased risk of infection, poor wound
healing, and increased mortality in non-cancer surgical patients with steroid-induced
hyperglycemia. There is also evidence to support that elevations in blood glucose are
associated with worsened outcomes in cancer patients. Much of this data comes from cancer
patients that are treated in an inpatient setting where blood glucose is routinely checked.
Limited data is available describing the fluctuations in blood glucose following
dexamethasone administration in cancer patients being managed in an outpatient setting, such
as the Anschutz Cancer Pavilion (ACP) Infusion Clinic. This study aims to characterize the
effects dexamethasone has on blood glucose in cancer patients by utilizing Continuous Glucose
Monitoring (CGM) devices. These devices are minimally invasive, are FDA approved, and can
produce real-time data of blood glucose fluctuations over a course of 3-7 days. By inserting
the devices under the skin of the abdomen, the investigators can evaluate the temporal
relationship between glucose abnormalities and dexamethasone administration. Results from
this study will not only increase the knowledge base of dexamethasone-induced hyperglycemia
and identify patients at increased risk, but also allow future research to be conducted in
order to determine if standard protocols can proactively minimize steroid-induced glucose
fluctuations.