We conducted this meta-analysis in accordance with 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analyses and Systematic Reviews of Observational Studies in Epidemiology) guidelines. Therefore, we conducted a meta-analysis in this study to compare the blood glucose changes, and wound healing in surgical patients with DM between a single dose of dexamethasone and no usage, and tried to confirm the safety of dexamethasone use for PONV prophylaxis in diabetic patients. With the global rising of diabetes mellitus (DM), it is unclear how a single dose of intravenous dexamethasone used pre/intraoperatively for PONV prophylaxis would influence the blood glucose and wound healing in diabetic patients. One recent meta-analysis showed that dexamethasone significantly increased blood glucose in non-diabetic surgical patients compared with control within 12 hours of surgery (Polderman et al. A single dose of dexamethasone in non-cardiac surgery can increase blood glucose till 24 hours after surgery (Perez et al. Long-term steroid use increases blood glucose level in both diabetic and non-diabetic patients (Perez et al. The protocol of this systematic review was registered in INPLASY with the registration number INPLASY202270002.ĭexamethasone is commonly used and very effective to prevent postoperative nausea and vomiting (PONV), and dexamethasone combined with 5-HT3 receptor antagonist is recommended as the first-line antiemetic for children (Gan et al. Thus, dexamethasone with a single dose could be safely used for PONV prophylaxis in diabetic patients. Conclusionĭexamethasone could increase blood glucose by only 2.014 mmol/L (36.252 mg/dL) of peak glucose level within 24 hours of surgery in surgery patients with DM, the increase of glucose level at each time point perioperatively was even lower, and had no effect on wound healing. It indicated that dexamethasone caused the increase of perioperative glucose level at different time points by 0.439 to 1.087 mmol/L (7.902 to 19.566 mg/dL), and the increase of peak glucose level within 24 hours of surgery by 2.014 mmol/L (36.252 mg/dL) compared with control. Nine randomized controlled trials (RCTs) and 7 cohort studies were included in our meta-analysis. The articles reporting a single dose dexamethasone administered intravenously for antiemesis in surgical patients with diabetes mellitus (DM) were included. The Pubmed, Cochrane Library, Embase, Web of Science databases, CNKI and Google Scholar were searched. It has been confirmed that long-term steroid use increases blood glucose level in both diabetic and non-diabetic patients, it is unclear how a single dose of intravenous dexamethasone used pre/intraoperatively for postoperative nausea and vomiting (PONV) prophylaxis would influence the blood glucose and wound healing in diabetic patients. Dexamethasone is commonly used for antiemesis in surgical patients.
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