Effect of intravitreal dexamethasone implant (Ozurdex®) in the glycemic control of patients with diabetic macular edema

Purpose To evaluate the effect of intravitreal dexamethasone implant (Ozurdex®) in the glycemic control of patients with diabetic macular edema (DME). Methods Ten patients with DME received an intravitreal injection (IVI) of dexamethasone implant (DXE implant, Ozurdex®). The mean age of patients was 72 years ± 13.3 years (range, 54–78 years). Glycated haemoglobin (HbA1C) was analyzed before and three months after IVI. The real‐time glycemic readings, throughout the day and night, during at least one week, are provided by a new medical device (Dexcom G4® Dexcom, Fr). The primary outcome analysis was the comparison of HbA1C test before and after IVI. Other data included blood glucose average, the percentage of time spent higher, lower and in glycemic target, and standard deviation over the period. Results The mean HbA1C test is 7.2% before IVI and 7.5% after IVI (p = 0.83). Recording of blood glucose was performed on an average of 10 days ± 3. There is no statistical difference for the mean blood glycemic levels before and after IVI. It was 155.4 ± 2323.1 mg/dl before IVI and 163.3 ± 32.8 mg/dl after IVI (p = 0.25). No significant difference was found between extreme values of blood glucose: the mean highest values was 321.1 mg/dl versus 349 mg/dl (p = 0.35), the mean lowest values was 54 mg/dl versus 64.57 mg/dl (p = 0.40).Conclusions This new continuous glucose monitoring system is indicated for detecting trends and tracking patterns in patients with diabetes. To our knowledge, this is the first study that analyses the glycemic control in human after DXE implant IVI with a daily continuous glucose monitoring. In this study, the use of intravitreal steroids in diabetic patients doesn’t alter glycemic control or increase blood glucose levels. These preliminary results must be confirmed by further studies with a larger cohort.