Efficacy of a basal bolus insulin protocol to treat prednisolone‐induced hyperglycaemia in hospitalised patients

Burt, Morton G.; Drake, Sophie M.; Aguilar-Loza, Norma; Esterman, Adrian; Stranks, Stephen N; Roberts, G. W.

doi:10.1111/imj.12680

Cited by 34 publications

(30 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The algorithm for the management of corticosteroid-induced hyperglycemia that we propose takes into account all these aspects. Basal bolus insulin therapy remains the most flexible option for patients, and includes three components: basal insulin, prandial insulin, and a supplemental correction-factor insulin [44]. Both prandial and basal insulin regimens and premixed insulin are equally effective [11].…”

Section: Insulinmentioning

confidence: 99%

Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem

2017

View full text Add to dashboard Cite

Glucocorticoids 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 (DM) or severely uncontrolled hyperglycemia in patients with known DM. Glucocorticoid-induced diabetes mellitus (GIDM) is a common and potentially harmful problem in clinical practice, affecting almost all medical specialties, but is often difficult to detect in clinical settings. However, scientific evidence is lacking regarding the effects of GIDM, as well as strategies for prevention and treatment. Similarly to nonsteroid-related DM, the principles of early detection and risk factor modification apply. Screening for GIDM should be considered in all patients treated with medium to high doses of glucocorticoids. Challenges in the management of GIDM stem from wide fluctuations in postprandial hyperglycemia and the lack of clearly defined treatment protocols. Together with lifestyle measures, hypoglycemic drugs with insulin-sensitizing effects are indicated. However, insulin therapy is often unavoidable, to the point that insulin can be considered the drug of choice. The treatment of GIDM should take into account the degree and pattern of hyperglycemia, as well as the type, dose, and schedule of glucocorticoid used. Moreover, it is essential to instruct the patient and/or the patient's family about how to perform the necessary adjustments. Prospective studies are needed to answer the remaining questions regarding GIDM.

show abstract

Section: Insulinmentioning

confidence: 99%

Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem

2017

View full text Add to dashboard Cite

show abstract

“…They demonstrate that a morning dose of prednisolone, as commonly prescribed, has little effect on overnight glucose concentration and predominantly causes hyperglycaemia in the afternoon and evening . This pattern of hyperglycaemia is present in patients receiving prednisolone who also receive glargine‐based basal‐bolus insulin . These studies suggest that glucose‐lowering therapy in prednisolone‐treated patients should take place between midday and midnight.…”

Section: Introductionmentioning

confidence: 92%

Treatment of prednisolone‐induced hyperglycaemia in hospitalized patients: Insights from a randomized, controlled study

Radhakutty

Stranks

Mangelsdorf

et al. 2017

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…Коррекция стероид-индуцированного НУО инсулином является самой эффективной ввиду возможности гибкого дозирования на фоне изменения дозы ГКС. В многочисленных исследованиях показано, что требуется большая доза прандиального инсулина ввиду более высокой гликемии в дневное и вечернее время [49,50].…”

Section: особенности коррекции гликемии при стероид-индуцированных наunclassified

Glucose Exchange Disorders in Patients Taking Glucocorticosteroids: Features of Clinical Manifestations and Correction

Селимов

Елисеева

Куринная

et al. 2019

Kuban. nauсh. med. vestnik

View full text Add to dashboard Cite

The review deals with the problem of carbohydrate metabolism disorders in patients undergoing corticosteroid therapy, relevant for specialists in various fields. The article describes the epidemiology and risk factors for the development of carbohydrate metabolism disorders when using glucocorticosteroids. Contemporary information is provided about the diagnostics, prevalence and pathogenesis of steroid-induced hyperglycemia. A particular attention is paid to current data on various disorders of carbohydrate metabolism in patients with a therapeutic profile. Main approaches to the correction of glycemia in the steroid-induced disorders of carbohydrate metabolism using modern therapy are considered elucidated.Conclusion.The widespread use of glucocorticosteroids, significant prevalence of the steroid-induced disorders of carbohydrate metabolism, features of the pathogenetic mechanisms of steroid-induced diabetes mellitus determine the need to create algorithms for the diagnosis and treatment of these conditions. A conclusion is made that rational glucose-lowering therapy that takes into account the pathogenetic and clinical aspects of the steroid-induced disorders of carbohydrate metabolism, can reduce the rate of macro- and microvascular complications.Conflict of interest: the authors declare no conflict of interest.

show abstract

Efficacy of a basal bolus insulin protocol to treat prednisolone‐induced hyperglycaemia in hospitalised patients

Cited by 34 publications

References 27 publications

Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem

Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem

Treatment of prednisolone‐induced hyperglycaemia in hospitalized patients: Insights from a randomized, controlled study

Glucose Exchange Disorders in Patients Taking Glucocorticosteroids: Features of Clinical Manifestations and Correction

Contact Info

Product

Resources

About