Glucocorticoid-Induced Hyperglycemia

Abstract Objectives Provide treatment guidelines for glucocorticoid-induced hyperglycemia and to understand the clinical implications of glucocorticoid-induced hyperglycemia. Methods The authors analyzed an electronic search (Medline) and a literature review of the pertinent articles published from...

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Bibliographic Details
Published in:The American journal of the medical sciences 2013-04, Vol.345 (4), p.274-277
Main Authors: Kwon, Soonho, MD, MS, Hermayer, Kathie L., MD, MS, Hermayer, Kathie, MD, MS
Format: Article
Language:English
Subjects:
Diabetes mellitus
Glucocorticoids
Glucocorticoids - adverse effects
Humans
Hyperglycemia
Hyperglycemia - chemically induced
Hyperglycemia - drug therapy
Hyperglycemia - epidemiology
Hyperglycemia - physiopathology
Hypoglycemic Agents - therapeutic use
Incidence
Internal Medicine
Treatment
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Summary:Abstract Objectives Provide treatment guidelines for glucocorticoid-induced hyperglycemia and to understand the clinical implications of glucocorticoid-induced hyperglycemia. Methods The authors analyzed an electronic search (Medline) and a literature review of the pertinent articles published from 1980 to September 2012. Results In patients treated with glucocorticoids, the odds ratio for development of new-onset diabetes mellitus has been reported to be 1.36 to 2.31. The prevalence of abnormal glucose metabolism in post renal transplant patients taking glucocorticoids has been reported to be 17% to 32%. Sustained glucocorticoid treatment increases the potential for future cardiovascular disease through multiple pathways, resulting in a trade-off between benefit and harm. Complications related to glucocorticoid treatments are associated with the total glucocorticoid dose and duration of therapy. Other risk factors include age and body mass index. Understanding the pharmacodynamics and clinical implications of glucocorticoid-induced hyperglycemia can promote recognition and improvement of its treatment. Conclusions Glucocorticoid-induced hyperglycemia has significant clinical implications in patients with diabetes mellitus and without diabetes mellitus. Early recognition and proper proactive management of glucocorticoid-induced hyperglycemia should enhance care for patients receiving glucocorticoid treatment. Furthermore, treatment has been effective for both the inpatient and the outpatient settings.
ISSN:0002-9629
1538-2990
DOI:10.1097/MAJ.0b013e31828a6a01