Introduction: Paediatric glucocorticoid-induced hyperglycemia (GIH) and diabetes are frequently under-recognized complications of cancer therapy. Early identification is essential, as delayed diagnosis may lead to severe metabolic consequences, including diabetic ketoacidosis (DKA). This study aims to characterize the clinical features, risk factors, and outcomes of GIH in a tertiary centre. Methodology: A descriptive cross-sectional study was conducted at the Paediatric Endocrinology Unit, University Malaya Medical Centre, reviewing cases from January 2023 to December 2025. Data were extracted from electronic records, including demographic, clinical, and treatment-related variables. Results: Twelve cases of GIH or diabetes were identified, including two presenting with DKA. Most patients had leukemia (92%), with a male predominance (75%). The median age was 13.6 years, and the median body mass index was 22.1 kg/m². Over half (54%) were overweight or obese, and 45% exhibited acanthosis nigricans. A family history of diabetes was present in 75% of cases. Hyperglycemia developed early in 66% of cases, typically within 2–5 days of initiating high-dose glucocorticoids. Median random blood glucose was 21.9 mmol/L, while median HbA1c was 6.4%. Half were symptomatic, most commonly with polyuria. Insulin therapy was required in 75% of cases, with a median duration of 26 days. Metformin was used in 50% of cases, often in combination with insulin. Most cases resolved following cessation of glucocorticoid therapy, except one who continues to receive metformin for a pre-diabetes state. Conclusion Adolescents, those with obesity, insulin resistance, and a positive family history of diabetes, represent highrisk groups for GIH. Importantly, GIH may present with life-threatening DKA. Routine glucose monitoring and risk stratification during glucocorticoid therapy are recommended. The development of local screening and management guidelines is crucial for improving early detection and optimizing patient outcomes.
Child ; Diabetic Ketoacidosis ; Glucocorticoids ; Neoplasms ; Hyperglycemia