A Prospective Study on Effectiveness of Steroid Stewardship on Glycemic Control Among Emergency Care Patients at A Tertiary Care Hospital

Background:Steroid stewardship encompasses the process of pre-prescription screening, judicious prescription, and provision of medical care during corticosteroid use, and diligent monitoring following discontinuation of corticosteroid therapy. Objective: This study aims to evaluate the glycemic levels and adverse events of corticosteroids in emergency care patients for various respiratory conditions at a tertiary care hospital. Materials and methods: A prospective cross-sectional study was conducted for six months in emergency care patients after obtaining ethical approval. Results: Totally 72 were enrolled with varoius respiratory disease, among them 18 patients were diabetic and 54 patients were non-diabetic receving various formulations of steroids. The glycemic levels were assessed using random blood sugar (RBS) which is in relation to steroid administration. The results show that 4 patients developed hyperglycemia (>200 mg/dl) after receiving steroids. Statistical analysis shows that there was no significant difference (p>0.05%) in RBS levels during before and after steroid administration in both diabetic and non-diabetic patients but, episodes of hyperglycemia after steroid administration was observed in both diabetic and non-diabetic patients with pneumonia and AECOPD. Conclusion: We conclude that steroid stewardship program is essential in monitoring and controlling glycemic levels, especially for diabetic patients presenting with infections.