Dexamethasone-associated hyperglycemia during chemotherapy in endometrial and ovarian cancer: a retrospective study.

Dexamethasone is a glucocorticoid routinely used as pre-medication during carboplatin-paclitaxel chemotherapy for ovarian and endometrial cancer treatment. However, its repeated administration may contribute to metabolic disturbances, including hyperglycemia. This study evaluated the association between cumulative dexamethasone exposure and longitudinal changes in random blood glucose levels in patients with ovarian or endometrial cancer. We conducted a retrospective study of patients with ovarian or endometrial cancer who received dexamethasone during chemotherapy between November 2012 and November 2025 and had available random glucose measurements. Linear regression assessed associations with body mass index, baseline diabetes status, and cumulative dexamethasone exposure. Overall, 150 patients with ovarian cancer and 150 patients with endometrial cancer were included. Ovarian cancer patients had a median body mass index of 25.1; patients with endometrial cancer had a median body mass index of 28.1. The median cumulative dexamethasone dose was 186 mg. Patients with endometrial cancer showed a higher burden of hyperglycemic events. In the endometrial cancer cohort, both pre-treatment glucose (odds ratio 1.47, 95% confidence interval 1.09 to 2.00, p = .012) and baseline diabetes status (odds ratio 5.85, 95% confidence interval 1.80 to 18.95, p = .003) were independently associated with pre-diabetic or diabetic spikes. These findings highlight the need for vigilant glucose monitoring during chemotherapy, particularly in patients with endometrial cancer with elevated body mass index. Larger prospective studies are warranted to confirm these observations.