Hyperglycemia and Diabetes Induced by Glucocorticoids in Nondiabetic and Diabetic Patients: Revision of Literature and Personal Considerations

Ceccarelli, Elena; Chiara, Mattaliano; Brazzi, Angelica; Chiara, Marinetti A; Nigi, Laura; Chirico, Chiara; Corallo, Claudio; Fioravanti, Antonella; Giordano, Nicola Giuseppe

doi:10.2174/1389201020666190102145305

Cited by 47 publications

(42 citation statements)

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“…Regarding safety, although intralesional injections are an easy procedure, care must be taken when performing them on diabetic patients, due to the possibility of producing glycaemic decompensation 20 . It would also be necessary to carry out an individual evaluation of the patient's mental health, given the potential of systemic corticosteroids to produce changes in behaviour, as already described in previous studies 21 , 22 .…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-assisted intralesional corticosteroid infiltrations for patients with hidradenitis suppurativa

Salvador‐Rodríguez

Arias‐Santiago

Molina-Leyva

2020

Sci Rep

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Corticosteroid infiltrations of lesions in hidradenitis suppurativa (HS) appear to be beneficial to acute flares. The aim of this study is to evaluate the effectiveness and safety of ultrasound-assisted intralesional corticosteroid infiltrations to HS lesions. Prospective cohort study between February 2017 and February 2019 on patients with mild to severe HS and one or more inflammatory lesions. The study intervention was ultrasound-assisted intralesional infiltration of triamcinolone acetonide 40 mg/ml. The main outcome was the complete response rate of infiltrated lesions versus non-infiltrated lesions. Two hundred and forty-seven infiltrated inflammatory lesions and 172 non-infiltrated lesions were included. At week 12, 81.1% (30/37) of nodules, 72.0% (108/150) of abscesses and 53.33% (32/60) of draining fistulas presented complete response versus 69.1% (47/68), 54.3% (38/70) and 35.3% (12/34) respectively for the non-infiltrated lesions. The Hurley stage negatively correlated with complete response for abscesses and draining fistulas at − 0.17 (SD 0.06) p < 0.01 and − 0.30 (SD 0.13) p < 0.02 respectively. Ultrasound-assisted corticosteroid infiltration is a useful technique for the treatment of inflammatory HS lesions, with high and sustained response rates, especially for abscesses and small to medium-size simple draining fistulas. The likelihood of response correlates negatively with the Hurley stage.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-assisted intralesional corticosteroid infiltrations for patients with hidradenitis suppurativa

Salvador‐Rodríguez

Arias‐Santiago

Molina-Leyva

2020

Sci Rep

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“…A lower prevalence of corticosteroid-responsive disease was recorded in T2DM group. This finding could indicate restricted use of these drugs in T2DM due the predictable adverse effects of glucocorticoid therapy on blood glucose levels (Wallace and Metzger, 2018;Ceccarelli et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients

et al. 2020

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Objectives: Little is known about the specific comorbidities contributing to higher costs in patients with type-2 diabetes mellitus (T2DM), particularly in older cases. We aimed to evaluate the prevalence, type, and cost of comorbidities occurring in older T2DM patients versus older non-T2DM patients, and the factors associated with high cost (HC) T2DM patients.Methods: Retrospective cohort study using information from the Campania Region healthcare database. People aged ≥65 years who received ≥2 prescriptions for antidiabetic drugs were identified as “T2DM patients.” Comorbidities among T2DM and non-T2DM groups were assessed through the RxRiskV Index (modified version). T2DM individuals were classified according to the total cost distribution as HC or “non-high cost.” Two sub-cohorts of HC T2DM patients were assessed: above 90th and 80th percentile of the total cost. Age- and sex-adjusted logistic regression models were created.Results: Among the T2DM cohort, concordant and discordant comorbidities occurred significantly more frequently than in the non-T2DM cohort. Total mean annual cost per T2DM patient due to comorbidities was €7,627 versus €4,401 per non-T2DM patient. Among T2DM patients identified as being above 90th and 80th percentiles of cost distribution, the total annual costs were >€19,577 and >€2,563, respectively. The hospitalization cost was higher for T2DM cases. Strongest predictors of being a HC T2DM patient were having ≥5 comorbidities and renal impairment.Conclusion: HC patients accrued >80% of the total comorbidities cost in older T2DM patients. Integrated care models, with holistic and patient-tailored foci, could achieve more effective T2DM care.

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“…Nephritic flares are difficult to manage and may lead to irreversible lesions, while proteinuric flares usually respond to treatment although remission may occur after weeks or months (92), Flares in patients with LMN are frequently associated with conversion to proliferative glomerulonephritis, as shown by repeat renal biopsy (93)(94)(95). Persistent nephrotic syndrome and prolonged use of corticosteroids can be responsible of dyslipidemia, diabetes, arterial hypertension, and hypercoagulability (96)(97)(98). There is agreement that patients with persistent nephrotic syndrome despite the use of RAS inhibitors should receive immunosuppressive therapy, while there is controversy about the use of immunosuppression in patients with subnephrotic proteinuria.…”

Section: Membranous Nephropathy Secondary To Immunological and Rheumamentioning

confidence: 99%

Secondary Membranous Nephropathy. A Narrative Review

Moroni

Ponticelli²

2020

Front. Med.

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Membranous nephropathy (MN) is a common cause of proteinuria and nephrotic syndrome all over the world. It can be subdivided into primary and secondary forms. Primary form is an autoimmune disease clinically characterized by nephrotic syndrome and slow progression. It accounts for ~70% cases of MN. In the remaining cases MN may be secondary to well-defined causes, including infections, drugs, cancer, or autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), urticarial vasculitis, sarcoidosis, thyroiditis, Sjogren syndrome, systemic sclerosis, or ankylosing spondylitis. The clinical presentation is similar in primary and secondary MN. However, the outcome may be different, being often related to that of the original disease in secondary MN. Also, the treatment may be different, being targeted to the etiologic cause in secondary MN. Thus, the differential diagnosis between primary and secondary MN is critical and should be based not only on history and clinical features of the patient but also on immunofluorescence and electron microscopy analysis of renal biopsy as well as on the research of circulating antibodies. The identification of the pathologic events underlying a secondary MN is of paramount importance, since the eradication of the etiologic factors may be followed by remission or definitive cure of MN. In this review we report the main diseases and drugs responsible of secondary MN, the outcome and the pathogenesis of renal disease in different settings and the possible treatments.

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Hyperglycemia and Diabetes Induced by Glucocorticoids in Nondiabetic and Diabetic Patients: Revision of Literature and Personal Considerations

Cited by 47 publications

References 0 publications

Ultrasound-assisted intralesional corticosteroid infiltrations for patients with hidradenitis suppurativa

Ultrasound-assisted intralesional corticosteroid infiltrations for patients with hidradenitis suppurativa

Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients

Secondary Membranous Nephropathy. A Narrative Review

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