Practical Guide to Glucocorticoid Induced Hyperglycaemia and Diabetes

Barker, Hannah L; Morrison, Deborah; Llano, Andrea; Sainsbury, Christopher; Jones, Gill

doi:10.1007/s13300-023-01393-6

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…General anaesthesia with intravenously administered anaesthetics exert a more profound impact on glucose metabolism compared to epidural anaesthesia with epidurally administered medication [ 42 ], and general anaesthesia with volatile anaesthetics having a more profound impact than total intravenous anaesthetics [ 43 ]. Furthermore, certain other types of medications, such as corticosteroids, can also induce hyperglycaemia [ 44 ]. The administration of substantial amounts of glucose through intravenous administration or enteral feeding can further contribute to hyperglycaemia [ 9 ].…”

Section: Alterations In Plasma Glucose Following Tbimentioning

confidence: 99%

Cerebral Glucose Metabolism following TBI: Changes in Plasma Glucose, Glucose Transport and Alternative Pathways of Glycolysis—A Translational Narrative Review

Gribnau,

van Zuylen,

Coles

et al. 2024

IJMS

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Traumatic brain injury (TBI) is a major public health concern with significant consequences across various domains. Following the primary event, secondary injuries compound the outcome after TBI, with disrupted glucose metabolism emerging as a relevant factor. This narrative review summarises the existing literature on post-TBI alterations in glucose metabolism. After TBI, the brain undergoes dynamic changes in brain glucose transport, including alterations in glucose transporters and kinetics, and disruptions in the blood–brain barrier (BBB). In addition, cerebral glucose metabolism transitions from a phase of hyperglycolysis to hypometabolism, with upregulation of alternative pathways of glycolysis. Future research should further explore optimal, and possibly personalised, glycaemic control targets in TBI patients, with GLP-1 analogues as promising therapeutic candidates. Furthermore, a more fundamental understanding of alterations in the activation of various pathways, such as the polyol and lactate pathway, could hold the key to improving outcomes following TBI.

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Section: Alterations In Plasma Glucose Following Tbimentioning

confidence: 99%

Cerebral Glucose Metabolism following TBI: Changes in Plasma Glucose, Glucose Transport and Alternative Pathways of Glycolysis—A Translational Narrative Review

Gribnau,

van Zuylen,

Coles

et al. 2024

IJMS

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“…The type of glucocorticoid and duration of action must be considered in determining insulin treatment regimens. For individuals who are on higher doses of glucocorticoids, an increase in the dosage of prandial and correctional insulin may be needed in addition to basal insulin [93]. The dose of correctional insulin is based on the dose of the administered glucocorticoid and the weight of the person [94].…”

Section: Cardiovascular Diseasementioning

confidence: 99%

A Practical Approach to the Initiation, Titration and Intensification of Insulin Therapy in Adults with Diabetes in the Indian Context: Recommendations by Association of Clinical Endocrinologists Consensus Group

Erukulapati,

M.,

Jakkidi

et al. 2024

Clin Diabetol

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Section: Management Of Hyperglycemia Induced By Prolonged Treatment W...mentioning

confidence: 99%

“…OGTT and glycated hemoglobin are not indicated for monitoring and screening patients who develop hyperglycemia induced by acute diabetes, unless otherwise indicated (Barker et al, 2023). The glycated hemoglobin test is of great importance before starting treatment in patients with a high chance of developing hyperglycemia and to exclude pre-existing diabetes (Barker et al, 2023;Nakamura et al, 2020;). Diabetic patients must check their blood glucose 4 times a day, whereas non-diabetics are recommended to check their blood glucose only once, unless their blood glucose levels are above 200mg/dL, thus changing the indication to 4 daily measurements.…”

Section: Management Of Hyperglycemia Induced By Prolonged Treatment W...mentioning

confidence: 99%

“…A blood glucose target between 108 mg/dL and 180 mg/dL is recommended for hospitalized patients. In groups at high risk of hypoglycemia or vulnerable to harm from hypoglycemia, milder glycemic targets can be used, aiming for levels between 108mg/dL and 270mg/dL (Aberer et al, 2021;Barker et al, 2023;Litty et al, 2017).…”

Section: Management Of Hyperglycemia Induced By Prolonged Treatment W...mentioning

confidence: 99%

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Corticosteroid-induced hyperglycemia

Ferreira,

Júca Neto,

Duarte Filho

et al. 2024

RSD

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Glucocorticoids are medications of wide medical use, notably due to their known anti-inflammatory effects. Furthermore, fluctuations in glycemic indexes stand out as risk factors for clinical and surgical complications, mortality and increased hospital stay. The study consists of an integrative and descriptive literature review, through the PUBMED platform with the following keywords: “Hyperglycemia”, “Glucocorticoid” and “Induce”, in the last 12 years and aims to gather and unify information regarding the understanding and clinical and therapeutic management of hyperglycemia induced by the use of corticosteroids and corticogenic diabetes. The fluctuation in glycemic indexes with the use of corticosteroid therapy is an imbalance between the increase in insulin resistance and the inhibition of insulin production and secretion at the pancreatic cellular level. Screening for Diabetes Mellitus in patients on corticosteroid therapy is based on consensus in the literature with a plasma glucose level above 125 mg/dL, any capillary measurement above 200 mg/dL, HbA1c> 6.5% or oral tolerance test glucose above 200mg/dL after 2 hours. The main glycemic target is capillary blood glucose between 108-180 mg/dL and in cases of initiating therapeutic approaches for hospital management of glycemic fluctuations, the use of insulin therapy is chosen. Hyperglycemia induced by the use of corticosteroids is a topic that has been gaining prominence in the medical scenario, despite the lack of studies that uniformly protocol the approach to patients when this scenario is confirmed, with the aim of reducing the risks associated with hospitalization.

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Practical Guide to Glucocorticoid Induced Hyperglycaemia and Diabetes

Cited by 8 publications

References 20 publications

Cerebral Glucose Metabolism following TBI: Changes in Plasma Glucose, Glucose Transport and Alternative Pathways of Glycolysis—A Translational Narrative Review

Cerebral Glucose Metabolism following TBI: Changes in Plasma Glucose, Glucose Transport and Alternative Pathways of Glycolysis—A Translational Narrative Review

A Practical Approach to the Initiation, Titration and Intensification of Insulin Therapy in Adults with Diabetes in the Indian Context: Recommendations by Association of Clinical Endocrinologists Consensus Group

Corticosteroid-induced hyperglycemia

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