Dexamethasone safe for COVID patients with diabetes, significantly reduces risk of death from virus

EDINBURGH, Scotland — Dexamethasone, an anti-inflammatory steroid, is proving to be a key weapon in the fight against COVID-19. Despite its effectiveness at preventing deaths from the virus, there have been concerns about severe side-effects among patients with diabetes. Now, a new study is putting some of those fears to rest. Researchers with the Society for Endocrinology say dexamethasone is a reliable COVID treatment, even for patients dealing with diabetes.

Overall, the new report finds dexamethasone cuts the risk of death from a severe coronavirus infection by 56 percent. This also includes the risk of patients needing to enter the ICU or needing a ventilator.

In cases of severe infection, scientists have discovered that COVID patients needing breathing support show signs of an overactive immune system — called the “cytokine storm.” Until now, there had been some concern about using an immunosuppressing steroid to treat this condition.

Even before the pandemic, the steroid had a reputation for increasing blood sugar levels in patients — a serious health risk for people with diabetes. Unfortunately, the urgency of the pandemic meant doctors had to act quickly to save lives — without knowing all the potential side-effects of using dexamethasone on certain patients.

“We really didn’t know how to manage it, we were learning as we went along. The RECOVERY trial showed that if you had COVID severe enough to need hospital treatment with a ventilator, then there was almost a third reduction in deaths for patients given dexamethasone,” explains lead investigator Dr. Victoria Salem in a media release.

Diabetes does not dampen COVID drug

To answer these questions, study authors examined COVID treatment outcomes during the first two waves of the pandemic. Specifically, they focused on the outcomes among patients with diabetes and any other complications due to high blood sugar levels. Researchers compared over 800 patients from the pandemic’s first wave, where no one received dexamethasone, to more than 1,300 patients from COVID-19’s second wave, treated with dexamethasone.

Along with cutting deaths in half, the team finds only a small portion of diabetic patients experienced severe complications from taking the drug. Among patients with diabetes, study authors note many needed extra medication to maintain their blood sugar levels. Moreover, diabetes did not weaken the effectiveness of dexamethasone against COVID-19 infections.

“We were concerned that dexamethasone was a double-edged sword for patients with diabetes, and while we did see an increase in steroid-induced diabetes and worsened diabetes, deaths were significantly reduced in wave two for all patients. We now feel confident using dexamethasone for patients with diabetes in the future, just with the caveat that it may result in a short-term worsening of their condition,” Dr. Salem concludes.

Researchers presented their findings at the Society for Endocrinology’s annual conference.