The Effect of Intense, Short-Term Topical Dexamethasone Disodium Phosphate Eyedrops on Blood Glucose Level in Diabetic Patients

Aim: To evaluate the influence of an intensive course of topical (ophthalmic drops) steroid (dexamethasone disodium phosphate) application on blood glucose levels in diabetic patients. Methods: Fifty-five diabetic (type 2) patients were randomly assigned to receive either corticosteroid (study group: 30 patients, 1 drop of 0.1% dexamethasone disodium phosphate) or balanced salt solution (BSS; control group: 25 patients) eyedrops, every 2 h for 7 days (8 drops/day). Blood glucose monitoring (venous blood sample) was performed at the same time every day (10:00 a.m.). Results: During the study no side effects (such as hypoglycemic/hyperglycemic crises) were observed in either study or control group. No statistically significant alterations in blood glucose levels were found (p = 0.19, paired t test) in either group. In the corticosteroid group, when we separately examined patients with controlled diabetes mellitus (initial glucose level ≤135 mg/dl), a statistically significant increase in blood glucose levels was found at the start of dexamethasone treatment (p = 0.003), but which returned to the pretreatment levels after discontinuation of dexamethasone drops. In contrast, similar results were not found for patients with uncontrolled diabetes mellitus (initial glucose level ≧135 mg/dl), while for control patients we did not find any statistically significant differences in any group. Conclusions: Intensive application of topical corticosteroids (drops) for a short period of time (7 days) seems to statistically raise the blood glucose levels in patients with controlled diabetes mellitus, which, however, return to pretreatment levels after discontinuation of eyedrops without any side effects.