Steroid-Induced Hyperglycemia in Patients Using Maxitrol

Mechanism and Effects

Dexamethasone, a component of Maxitrol, leads to hyperglycemia through multiple pathways, including impaired beta cell insulin secretion, increased total body insulin resistance, and enhanced hepatic gluconeogenesis 1, 2
The hyperglycemic effect typically peaks 7-9 hours after dexamethasone administration 1
The degree of hyperglycemia correlates directly with the steroid dose 1

For patients on topical steroids like Maxitrol who have diabetes or are at risk, monitor blood glucose levels, particularly 6-9 hours after application when hyperglycemic effects peak 1
Consider temporary adjustments to diabetes medications if hyperglycemia is significant 3
Educate patients about symptoms of hyperglycemia to monitor for 2
If severe or persistent hyperglycemia occurs, consult with the patient's primary care physician or endocrinologist 4