Intravenous Dexamethasone Transiently Elevates Blood Glucose Levels and Reduces Pain After TKA in Patients with Type-2 Diabetes Mellitus
Bibliographic record
Abstract
BACKGROUND: Effective perioperative blood glucose control is crucial for reducing postoperative complications in patients with diabetes mellitus (DM) who are undergoing total knee arthroplasty (TKA). The aim of this study was to assess the impact of intravenous (IV) dexamethasone on blood glucose levels, insulin requirements, postoperative pain, and postoperative nausea and vomiting (PONV) in patients with well-controlled type-2 DM. METHODS: A total of 83 Asian patients with well-controlled type-2 DM (defined as a preoperative glycated hemoglobin level of ≤7.0%) undergoing primary TKA were randomized to receive either IV dexamethasone or normal saline solution. Blood glucose and insulin requirements were monitored postoperatively up to day 5, and pain and PONV were assessed using a numeric rating scale. RESULTS: Compared with the control, IV dexamethasone transiently elevated blood glucose levels on the day of surgery and on postoperative day 1, with the levels returning to baseline by day 3. Insulin requirements were higher in the intervention group on postoperative day 1 (p = 0.004). While IV dexamethasone did not significantly reduce PONV, it effectively alleviated postoperative pain up to day 3. CONCLUSIONS: In patients with DM who underwent TKA, IV dexamethasone administration transiently increased blood glucose on the day of surgery and on postoperative day 1 and elevated insulin requirements on postoperative day 1. Despite having no impact on PONV, IV dexamethasone provided clinical benefits by reducing early postoperative pain. These findings suggest the potential benefits of IV dexamethasone in enhancing perioperative management strategies for patients with DM who are undergoing TKA. LEVEL OF EVIDENCE: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".