Referencing a retrospective, singular snapshot in the past when my A1C was 5.5 does little to account for and/or acknowledge the basic, simple and  irrefutable fact that BOTH Prednisone and Dexamethasone/Decadron  [ two medications that even Duke University researchers have cited in connnection to "steriod induced diabetes" ]   were prescribed for and administered to a patient experiencing heart failure AFTER that A1C test result - and that immediately following those decisions to the present day my body has struggled to recalibrate its former more natural ability to regulate glucose.  And while it may be an inconvenient truth to either digest or accept that prior to those decisions it was reasonable to suggest that my diagnosis was "well controlled diabetes mellitus" 一 my diabetes is no longer well controlled 一 but rather way out control.   But inspite of those irrefutable facts and the noted instability recorded in my Daily Vitals, the patient  recommendation still to date is to test daily glucose levels once a day 一 only hours after the patient has reported that they have run out of testing strips. Duly noted. 

Supplemental Presentation Slides & Handouts:

• Glucose Volatility & Cardiac Safety
  
  

• Data Denial & Patient Survival 

Relevant Research from Duke University Researchers: 

• Even in Low Doses, Prednisone Creates Insulin Resistance
   

• Postoperative hyperglycemia after 4- vs 8-10-mg dexamethasone for postoperative nausea and vomiting prophylaxis in patients with type II diabetes mellitus: a retrospective database analysis  
   

• Innovative predictive model to anticipate steroid-induced hyperglycemia and guide insulin regimens: Keep blood from getting too sweet
  
  

• Continuous glucose monitoring for steroid induced hyperglycemia in breast cancer patients 

Duke University researchers have extensively studied the intersection of steroid use, hyperglycemia, and cardiovascular health. While research often addresses these factors separately, several Duke studies highlight how steroid-induced blood sugar spikes directly impact cardiac patients.

Impact on Heart Failure Patients

• Increased Risk of Heart Failure: A collaborative study involving Duke researchers published in PMC indicates that oral glucocorticoids (like Prednisone) are associated with a dose-dependent increase in the risk of heart failure (adjusted odds ratio of 2.66). These effects can unmask subclinical heart failure in at-risk subjects due to steroid-induced hypertension and mineralocorticoid receptor activation.
  
  

• Adverse Cardiac Events: Duke research published in Duke Scholars warns that glucocorticoids can increase the incidence of left ventricular free wall rupture by delaying myocardial scar formation after a heart attack. This study concludes that steroids should be used judiciously in patients with existing cardiovascular risk factors.
  
  

• Insulin Requirements in Heart Surgery: In the largest randomized trial of its kind, Duke Health researchers found that steroids given during heart surgery significantly elevated blood sugar levels, requiring insulin therapy in 19% of patients compared to only 8% in the placebo group.
  
  
  

Impact on Pacemaker Patients

• Steroid-Eluting Electrodes: Duke research has examined the use of dexamethasone specifically within pacemaker technology. A study on PubMed investigated the electrophysiologic effects of high-dose dexamethasone, finding that it can reduce cardiac stimulation thresholds, which is why many modern pacemaker leads are "steroid-eluting" to prevent inflammation at the implant site.
  
  

Arrhythmia and Steroids: While steroids are used to improve pacemaker function, high systemic doses have been reported to cause cardiac arrhythmias in 1% to 82% of patients, according to broader reviews cited by PMC. 

nisone & Dexamethasone/Decadron ] within a 2-4week time period just days ago that even researchers at Duke University cite as causing glucose spikes or "steroid induced diabetes.” .