Evaluation of the Effects of Exenatide Administration in Patients with Type 2 Diabetes with Worsened Glycemic Control Caused by Glucocorticoid Therapy

Matsuo, Koji; Nambu, Takuo; Matsuda, Yuki; Kanai, Yugo; Yonemitsu, Shin; Muro, Seiji; Oki, Shogo

doi:10.2169/internalmedicine.52.8622

Cited by 25 publications

(15 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Corticosteroids are used for induction therapy, maintenance therapy, and treating organ rejection. Prednisone and methylprednisolone have each been shown to dose dependently induce hyperglycemia, increase insulin resistance and hepatic gluconeogenesis, inhibit insulin secretion, and potentiate the effects of glucoregulatory hormones such as glucagon and epinephrine (14,15). Incremental dose increases of 0.1 mg/kg prednisolone per day was shown to correlate with a 5% increased risk of NODAT and a 4% increased risk of impaired glucose tolerance in a study evaluating renal transplant patients (16).…”

Section: Mechanisms Of Dysglycemia By Immunosuppressive Drugsmentioning

confidence: 99%

The Rationale for use of Incretins in the Management of new Onset Diabetes After Transplantation (NODAT)

Sadhu¹,

Schwartz²,

Herman³

2015

Endocrine Practice

View full text Add to dashboard Cite

Section: Mechanisms Of Dysglycemia By Immunosuppressive Drugsmentioning

confidence: 99%

The Rationale for use of Incretins in the Management of new Onset Diabetes After Transplantation (NODAT)

Sadhu¹,

Schwartz²,

Herman³

2015

Endocrine Practice

View full text Add to dashboard Cite

“…30,31 A perfusão intravenosa de exenatido demonstrou também melhorar significativamente a hiperglicémia induzida pelos GC, associando-se a um aumento da secreção de insulina e diminuição das concentrações de glucagon. 30,32 Apesar dos benefícios demonstrados, a sua utilização associa-se a elevado custo e a sua aplicabilidade nos doentes com DM induzida pela corticoterapia ainda está em estudo.…”

Section: Tratamentounclassified

Management and Treatment of Glucocorticoid-induced Diabetes Mellitus

Marques¹,

Bastos²,

Martins³

et al. 2019

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo

View full text Add to dashboard Cite

Introdução: O advento da terapêutica com glucocorticóides dirigida às doenças auto-imunes nos anos 40 levou à descoberta dos seus efeitos metabólicos adversos. Estes mimetizam o efeito dos glucocorticóides endógenos, com efeitos a nível da célula beta pancreática, levando à sua disfunção, e tecidos periféricos, com desenvolvimento de resistência à insulina. Os doentes idosos, com excesso de peso, com corticoterapia de longa duração e em altas doses apresentam maior risco de desenvolvimento de diabetes mellitus induzida pela corticoterapia. Esta é responsável pelo aumento no número de internamentos hospitalares, risco de infeção e diminuição da função do enxerto em doentes submetidos a transplante de órgão sólido. Este artigo tem como objetivo rever a fi siopatologia, fatores de risco, diagnóstico e os princípios de tratamento da diabetes mellitus induzida pela corticoterapia. Métodos: Foi realizada uma revisão sistemática da literatura na base de dados da PubMed de artigos publicados sobre esta temática até abril de 2017. Os termos de pesquisa utilizados foram «diabetes», «glucocorticoid», «steroid» «treatment», «management» e «effect». Conclusão: Os desafi os associados a esta entidade nosológica prendem-se com a fl utuação glicémica pós-prandial e com a ausência de consensos e protocolos de tratamento claramente defi nidos. A principal opção terapêutica é a insulina, adaptada ao tipo de glucocorticóide e à sua posologia.

show abstract

“…Intravenous exenatide improved blood glucose in healthy subjects taking high-dose prednisolone for 2 days (81). However, apart from case reports (82), longer-term data on the efficacy of GLP-1 agonists in patients taking prednisolone is lacking. Liraglutide has not been studied in patients on prednisolone but its non-glycaemic effects are favourable as it can cause weight loss and reduce fracture and cardiovascular risk (73,83).…”

Section: How Should Prednisolone-induced Diabetes Be Treated?mentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Critical review of the evidence underlying management of glucocorticoid-induced hyperglycaemia

Radhakutty

Burt

2018

European Journal of Endocrinology

View full text Add to dashboard Cite

Glucocorticoids are frequently prescribed to patients with a wide range of inflammatory and autoimmune diseases. The semi-synthetic glucocorticoid prednisolone is most commonly prescribed and in two main patterns. Prednisolone is prescribed short-term at medium-high doses to treat an acute inflammatory illness or long-term at lower doses to attenuate chronic inflammatory disease progression. In hospitalized patients with acute prednisolone-induced hyperglycaemia there is a distinct circadian pattern of glucose elevation, which occurs predominantly in the afternoon and evening. As a morning dose of isophane insulin has a pharmacokinetic pattern that matches this pattern of glucose elevation, treatment comprising a basal dose of morning isophane insulin in combination with short-acting insulin boluses is generally recommended. However, evidence is lacking that isophane-based basal bolus insulin is more efficacious than other insulin regimens. In outpatients, low dose prednisolone causes a small increase in post glucose-load glucose concentration but no change in overall glycaemic control as measured by glycosylated haemoglobin. If treatment is indicated, metformin has been shown to be effective and may attenuate other adverse effects of long-term prednisolone therapy. Further studies are necessary in order to identify factors underlying the variability in response to insulin therapy and clinical benefits of treatment in hospitalized patients with prednisolone-induced hyperglycaemia. In outpatients prescribed low dose prednisolone, the cardiovascular risk associated with postprandial hyperglycaemia and efficacy of hypoglycaemic therapies should be evaluated in future randomized clinical trials.

show abstract

Evaluation of the Effects of Exenatide Administration in Patients with Type 2 Diabetes with Worsened Glycemic Control Caused by Glucocorticoid Therapy

Cited by 25 publications

References 34 publications

The Rationale for use of Incretins in the Management of new Onset Diabetes After Transplantation (NODAT)

The Rationale for use of Incretins in the Management of new Onset Diabetes After Transplantation (NODAT)

Management and Treatment of Glucocorticoid-induced Diabetes Mellitus

MANAGEMENT OF ENDOCRINE DISEASE: Critical review of the evidence underlying management of glucocorticoid-induced hyperglycaemia

Contact Info

Product

Resources

About