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Advised To Take Decadron For Allergic Swelling. Having Hypoglycemia But Not Diabetic. Done With Lab Tests. Should I Be Worried?

Posted on Sat, 14 Sep 2013

Question: Good afternoon.
I was give one time dose of decadron IV last evening for allergic swelling. No significant past medical history and on wellbutryin. One of the side effects is hyperglycemia, even in non diabetics, which is me. This morning my blood sugrar is 144 fasting. Should I expect to see this rate of rise in blood sugar ? How long will this last? Any interventions?
Also the lab works done last night indicated that GFR 59, should it be higher than 89? Thank you.

Answered by Dr. Venkat Sivayogi (33 minutes later)

Brief Answer:
Possibility of Diabetes.

Detailed Answer:
Hi,
Welcome to Healthcare Magic,

As per the description of your symptoms,there is more possibility of confirmed diabetes in your case. Because with single dose of Decadron we cannot see such a rise in sugar levels.
Generally hyperglycemia with corticosteroids (decadron,cortisone) is seen after usage of months in chronic diseases like connective tissue diseases and auto-immune conditions.

So I suspect there is possibility of Diabetes in your case. to confirm this, you need to consult a endocrinologist and get done FBS(fasting blood sugar) and Post-prandial blood sugar after 2hrs of 75grams oral glucose. This entire test is named as OGTT(oral glucose tolarance test).

Normal GFR results range from 90 - 120 mL/min/1.73 m2. But in your case, GFR is 59 which is below normal limits. So you need to get other tests to know renal function like Blood urea,serum creatinine and serum elelctrolytes.

Hope i have cleared up your query.
If you need any further clarifications,let me know.

regards,
DR.SIVAYOGI

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Venkat Sivayogi (3 hours later)

Hi Dr. Sivayogi,
Thank you for answering my question.
In regards to kidney function labs needed, I have a copy from last night's ER lab results.
Sodium level 140
Potassium level 4.2
Chloride 104
CO2 25
Anion Gap 11
Glucose 119
BUN 17
Creatinine 0.74
GFR *>59
Calcium level 9.0
TSH 1.820
Troponin I *0.00
Troponin I Interpretation *<0.07ng/ml NC

My blood sugar at 340 pm today decreased to 114.

How do you feel the rest of my labs look for kidney function and why is their an asterisk next to GFR and it is not indicated as L or H like the glucose.

What to feel about my blood sugar decreasing from 144 fasting this morning to 114 at 340 pm. I ate two eggs with onion, pam cooking spray, coffee black, and for snack had coffee with whipped cream and cinnamon and cheese stick.

Thank you, XXXXXXX Rioux-Nivens

Answered by Dr. Venkat Sivayogi (15 hours later)

Brief Answer:
Excluded renal disease but need to rule out DM.

Detailed Answer:
Hi,
Welcome back,

Sorry for much delay due to some internet issues.

I have gone through your lab tests. All your renal function tests are normal including blood urea,serum creatinine ,serum electrolytes also your GFR. you have mentioned clearly that your GFR value is >59, its a great relief for you because, kidney disease should be considered when GFR is below 60 only (according to clinical guidelines).

Now coming to your next query about asterisk before GFR value- Its actually given by a laboratory which denotes any reference value or method of doing GFR .For additional details you can see the bottom of your report for its significance.

Next coming to your blood sugar levels, according to ADA guidelines(american diabetology association) , Fasting blood sugar more than 126mg/dl is considered as diabetes. So i suggest you to better take OGTT test which gives better clarity on this issue.

Hope you are better clarified now.
If you have any further issues ,let me know.
Regards,
DR.SIVAYOGI

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar