Intraoperative Dosing of Dexamethasone in Type II Diabetics Undergoing Bariatric Surgery

Doctoral Candidate Name: 
Natalie Gabhart
Program: 
Doctor of Nursing Practice
Abstract: 

Purpose: Identifying trends in the intraoperative dosing of dexamethasone in type II diabetic patients undergoing bariatric procedures at a community hospital to determine impact of the dose received on perioperative glycemic control.

Background: Dexamethasone is a corticosteroid and despite its many documented benefits when administered perioperatively to surgical patients, it is often withheld in the type II diabetic population out of concern for postoperative hyperglycemia.

Methods: Retrospective chart reviews of 36 type II diabetics receiving dexamethasone undergoing bariatric procedures was completed. Inclusion criteria: type II diabetics, procedures <4 hours, patients with a HbA1C reading 6.5-8.9%, patients who are non-pregnant, patients with an ASA classification of I, II, or III, and who are not taking chronic steroids.

Results: Of the 36 perioperative glycemic trends reviewed, there was a significant increase (t = 8.72, p<0.001) between the preoperative and immediate postoperative blood glucose readings for dexamethasone doses 4-10 mg (p <0.011). This increase was not associated with age, HbA1C, or surgery length. The dose level itself did not influence actual BG level changes (t = -.87, p = .390).

Conclusion: Dexamethasone increases postoperative BG significantly in DMII patients undergoing bariatric surgery in the immediate postoperative period. However, it should be noted that there was not a significant difference between preoperative BG and the 24-hour postoperative BG level. Two patients who did not receive dexamethasone also showed an increase in BG that approached significance (p = .060). These results suggest that further study on the effects of dexamethasone dosing and perioperative glycemic control is necessary.

Key words: Hemoglobin A1C (HbA1C), dexamethasone, diabetic II, type 2, bariatric, intraoperative

Defense Date and Time: 
Friday, December 8, 2023 - 10:00am
Defense Location: 
CHHS 436
Committee Chair's Name: 
Dr. Stephanie Woods
Committee Members: 
Dr. Katie Shue-McGuffin, Dr. Danielle Brown, Dr. Catherine Helms, Dr. Suzanne Boyd


The Graduate School and the Graduate Admissions office in the Reese Building, Fifth Floor, is temporarily closed to allow contractors to complete some needed work in the space safely.

Learn More