Management of Steroid-induced Hyperglycemia.
10.4093/jkd.2016.17.3.174
- Author:
Sunghwan SUH
1
;
Mi Kyoung PARK
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea. pmk02@dau.ac.kr
- Publication Type:Original Article
- Keywords:
Corticosteroids;
Diabetes mellitus;
Hyperglycemia
- MeSH:
Adrenal Cortex Hormones;
Clinical Protocols;
Diabetes Mellitus;
Glucose;
Glucose Intolerance;
Humans;
Hyperglycemia*;
Hypoglycemic Agents;
Insulin;
Insulin Resistance;
Life Style;
Prognosis;
Risk Factors;
Steroids
- From:Journal of Korean Diabetes
2016;17(3):174-184
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Steroids are widely used as potent anti-inflammatory and immunosuppressive drugs to treat a wide range of diseases. However, they are also associated with a number of side effects including new-onset hyperglycemia in patients without a history of diabetes mellitus or severely uncontrolled hyperglycemia in patients with known diabetes mellitus. This negative effect is believed to be caused by a variety of factors, including increased insulin resistance, increased glucose intolerance, reduced beta-cell mass from beta-cell dysfunction, and increased hepatic insulin resistance leading to impaired suppression of hepatic glucose production. Steroid-induced hyperglycemia is important in clinical practice because it has been associated with deleterious effect on prognosis. However, there is no scientific evidence regarding the consequences of corticosteroid-induced hyperglycemia and clinical studies investigating the effects of prevention and correction of the condition are lacking. Similar to non-steroid-related diabetes, the principles of early detection and risk factor modification apply. Challenges in the management of steroid-induced diabetes stem from wide fluctuations in post-prandial hyperglycemia and the lack of clearly defined treatment protocols. Together with, or after, life style measures, hypoglycemic drug with important insulin sensitizer effects is indicated. Other oral hypoglycemic drugs or insulin therapy can be considered as the drug of choice. These treatments may provide additional long-term survival benefit and improve glycemic control.
