Glucose disturbances in non-diabetic patients receiving acute treatment with methylprednisolone pulses

Pérez, Hernán; Ossio, María Dolores Gómez de; Flores, Dania Lizeth Quintanilla; Coria, Mayra Ivonne Hernández; Peña, Alejandra Lorena Tamez; Pérez, Gissén Jazmín Cuz; Peña, Stephanie Lissette Proskauer

doi:10.1590/s0104-42302012000100025

Cited by 14 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The slightly higher baseline BMI in the MCALP group patients might in part contribute to the change discrepancy in the fasting blood glucose between these two groups, that likely to increase fasting blood glucose levels 23 . The pulsed methylprednisolone used might cause a loss of pancreatic adaptive response due to an acute and supra-physiological steroid load 24 , it also might cause different types of beta-cell dysfunction 23 , 25 , 26 . The fasting blood glucose levels in these two groups of patients were within the normal range.…”

Section: Resultsmentioning

confidence: 99%

Effect of pulsed intravenous methylprednisolone with alternative low-dose prednisone on high-risk IgA nephropathy: a 18-month prospective clinical trial

Li,

Fu,

Gao

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Full-dose prednisone (FP) regimen in the treatment of high-risk immunoglobulin A nephropathy (IgAN) patients, is still controversial. The pulsed intravenous methylprednisolone combined with alternative low-dose prednisone (MCALP) might have a more favorable safety profile, which has not been fully investigated. Eighty-seven biopsy-proven IgAN adult patients and proteinuria between 1 and 3.5 g/24 h after ACEI/ARB for at least 90 days were randomly assigned to 6-month therapy: (1) MCALP group: 0.5 g of methylprednisolone intravenously for three consecutive days at the beginning of the course and 3rd month respectively, oral prednisone at a dose of 15 mg every other day for 6 months. (2) FP group: 0.8–1.0 mg/kg/days of prednisone (maximum 70 mg/day) for 2 months, then tapered by 5 mg every 10 days for the next 4 months. All patients were followed up for another 12 months. The primary outcome was complete remission (CR) of proteinuria at 12 months. The percentage of CR at 12th and 18th month were similar in the MCALP and FP groups (51% vs 58%, P = 0.490, at 12th month; 60% vs 56%, P = 0.714, at 18th month). The cumulative dosages of glucocorticoid were less in the MCALP group than FP group (4.31 ± 0.26 g vs 7.34 ± 1.21 g, P < 0.001). The analysis of the correlation between kidney biopsy Oxford MEST-C scores with clinical outcomes indicated the percentages of total remission was similar between two groups with or without M1, E1, S1, T1/T2, and C1/C2. More patients in the FP group presented infections (8% in MCALP vs 21% in FP), weight gain (4% in MCALP vs 19% in FP) and Cushing syndrome (3% in MCALP vs 18% in FP). These data indicated that MCALP maybe one of the choices for IgAN patients with a high risk for progression into ESKD.Trial registration: The study approved by the Chinese Clinical Trial Registry (registration date 13/01/2018, approval number ChiCTR1800014442, https://www.chictr.org.cn/).

show abstract

Section: Resultsmentioning

confidence: 99%

Effect of pulsed intravenous methylprednisolone with alternative low-dose prednisone on high-risk IgA nephropathy: a 18-month prospective clinical trial

Li,

Fu,

Gao

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…MP is a glucocorticoid with a wide range of effects, including changes to metabolism. The use of MP can induce both glucose and insulin levels in non-diabetic SCI patients [ 25 , 26 ], and the higher blood sugar levels are further taken up by cells and processed as glycolytic metabolism (glycolysis). However, with excessive glycolysis but a low oxygen supply (due to damage to the vasculature of the spinal cord), oxidative phosphorylation in mitochondria cannot completely proceed, resulting in cellular acidosis (lactate acid, uric acid, oxalate, citric acid, etc.…”

Section: Discussionmentioning

confidence: 99%

Exerting the Appropriate Application of Methylprednisolone in Acute Spinal Cord Injury Based on Time Course Transcriptomics Analysis

Yang

Tsai

Juan

et al. 2021

IJMS

View full text Add to dashboard Cite

Methylprednisolone (MP) is an anti-inflammatory drug approved for the treatment of acute spinal cord injuries (SCIs). However, MP administration for SCIs has become a controversial issue while the molecular effects of MP remain unexplored to date. Therefore, delineating the benefits and side effects of MP and determining what MP cannot cure in SCIs at the molecular level are urgent issues. Here, genomic profiles of the spinal cord in rats with and without injury insults, and those with and without MP treatment, were generated at 0, 2, 4, 6, 8, 12, 24, and 48 h post-injury. A comprehensive analysis was applied to obtain three distinct classes: side effect of MP (SEMP), competence of MP (CPMP), and incapability of MP (ICMP). Functional analysis using these genes suggested that MP exerts its greatest effect at 8~12 h, and the CPMP was reflected in the immune response, while SEMP suggested aspects of metabolism, such as glycolysis, and ICMP was on neurological system processes in acute SCIs. For the first time, we are able to precisely reveal responsive functions of MP in SCIs at the molecular level and provide useful solutions to avoid complications of MP in SCIs before better therapeutic drugs are available.

show abstract

“…On the other hand, Feldman-Billard et al stated that blood glucose monitoring is not necessary in patients without diabetes because their blood glucose levels decrease from midnight to morning ( 10 ). However, another report warned that blood glucose monitoring is necessary because the fasting blood glucose levels increased in 98% of patients ( 11 ). Surprisingly, no previous studies have addressed the detailed effects of MP pulse therapy on blood glucose, e.g., the extent to which the blood glucose levels are affected and the time of day that they are affected - which may explain the controversy.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Mitiglinide and Repaglinide on Postprandial Hyperglycemia in Patients Undergoing Methylprednisolone Pulse Therapy

et al. 2018

View full text Add to dashboard Cite

Abstract:One adverse effect of methylprednisolone (MP) pulse therapy is an acute dose-dependent increase in the blood glucose level. Five patients with thyroid ophthalmopathy but normal glucose tolerance received MP pulse therapy (3 cycles, 3 days/week) and were assessed by continuous glucose monitoring. Steroid therapy increased the mean sensor glucose level, and all patients developed steroid-induced diabetes. The patients were treated alternately with mitiglinide (30 mg/day) and repaglinide (1.5 mg/day) during the second or third MP pulse therapy. The sensor glucose levels before lunch and dinner were more favorable during treatment with repaglinide than during treatment with mitiglinide. Repaglinide may be more clinically appropriate than mitiglinide.

show abstract

Glucose disturbances in non-diabetic patients receiving acute treatment with methylprednisolone pulses

Abstract: Methylprednisolone pulses produced significant increases in fasting glucose in most patients without diabetes. Further studies are needed to define its role in long-term consequences.

Cited by 14 publications

References 12 publications

Effect of pulsed intravenous methylprednisolone with alternative low-dose prednisone on high-risk IgA nephropathy: a 18-month prospective clinical trial

Effect of pulsed intravenous methylprednisolone with alternative low-dose prednisone on high-risk IgA nephropathy: a 18-month prospective clinical trial

Exerting the Appropriate Application of Methylprednisolone in Acute Spinal Cord Injury Based on Time Course Transcriptomics Analysis

The Effects of Mitiglinide and Repaglinide on Postprandial Hyperglycemia in Patients Undergoing Methylprednisolone Pulse Therapy

Contact Info

Product

Resources

About