Like hydroxychloroquine and remsdemvir before it, dexamethasone, an anti-inflammatory corticosteroid, has recently become a Covid-19 cure hopeful. 

The U.S. National Institutes of Health (NIH) recommends it for severe hospitalized COVID-19 patients who are on mechanical ventilators or need supplemental oxygen. 

If you don’t have severe symptoms of the disease caused by the SARS-CoV-2 virus, don’t take dexamethasone prophylactically. That’s because corticosteroids may be harmful if given for less severe COVID-19 infection.

In severe cases of Covid-19, there’s one underlying physiological action called a cytokine storm. This is when the immune system goes haywire, attacking everything in sight, including healthy organ tissue such as the alveoli (air sacs) in the lungs. By controlling inflammation, dexamethasone may stop the cytokine storm from progressing. 

According to FiercePharma, research showed the drug reduced risk of death by 35% for patients on ventilators and 20% for those receiving oxygen; the medicine also reduced 28-day mortality by 17%. 

Unfortunately, for those with diabetes, the drug’s life-saving potential might not be so potent—especially if blood sugar levels are high. 

Why Isn’t “Dex” As Effective For Those With Diabetes?

One consequence of having diabetes is that it may cause low levels of a protein in the blood called albumin. News Medical Life Sciences explains that albumin, which is made in the liver, plays two primary roles. First, it prevents fluids in the blood from leaking into tissues. And second, it carries substances like vitamins, enzymes, hormones and active ingredients in drugs and takes them where they are most needed, like the lungs, in the case of a severe Covid-19 patient. 

Having low serum (blood) albumin levels, then, interferes with the ability of albumin to transport dexamethasone (henceforth: “dex”) to the lungs. Low albumin was already established as a major risk factor for severe COVID-19, as is diabetes.

What the new research shows is how low albumin interferes with dex’s ability to calm a hyperactive immune response. High blood sugar, the researchers suggest, may alter the binding site for dex. And for those with diabetes who take other drugs to manage co-morbidities, those additional medications “may also compete with dexamethasone for the limited space in serum albumin’s cargo holds,” says News Medical Life Sciences.

Can Patients With Diabetes Take Extra Dex?

If only it were that easy a solution. Increasing the dosage of dex for patients with either diabetes and/or low serum albumin levels can produce harmful side effects. 

Dex, which was first approved for medical use in 1961, was originally intended for severe allergies. These days, the drug is used for a wide variety of inflammatory conditions such as digestive disorders and arthritis. 

The consequences of taking the drug inappropriately may result in the weakening of the immune system. And like the bladder-pain medication, Elmiron, long-term usage of dex may cause eye damage. MedicalNewsToday.com also lists heart damage, severe allergic reactions, infections and measles or chickenpox as adverse reactions to the drug. 

These complications may arise because dex synthetically mimics cortisol, the so-called stress hormone. High cortisol levels in the body may produce the one condition that interferes with dex’s ability to battle severe Covid-19 lung distress: diabetes. In addition, high cortisol can increase the risk for developing cardiovascular disease and osteoporosis. 

Manage Blood Sugar Levels And Stress

Hopefully, you won’t need to take dex for severe Covid-19 symptoms. To prevent your chances of contracting the virus, keep your blood sugar levels steady and your insulin levels low by eating a diet devoid of refined carbohydrates and sugars of all kinds (honey, molasses, corn syrup, cane sugar, etc.). Managing stress (meditation, deep breathing, walking, gardening, etc.) also plays an important factor in blood glucose regulation.