Steroid-induced hyperglycaemia in hospitalised patients: does it matter?

Cheung, N. Wah

doi:10.1007/s00125-016-4116-z

Cited by 16 publications

(11 citation statements)

References 10 publications

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“…In spite of hyperglycemia, the primary outcome (e.g. time to clinical stability) was not inferior for patients with diabetes and this was confirmed by a regression analysis, supporting the concept that the presence of diabetes or SIH did not modify the benefit of prednisone therapy in this clinical situation [124]. Interestingly, the amount of insulin among patients with diabetes under prednisone was no greater than for those with diabetes on placebo; on the contrary, among patients without diabetes, those administered with prednisone received a larger amount of insulin compared to the placebo group [123].…”

Section: Transient Hyperglycemia: What To Do?supporting

confidence: 56%

Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? A narrative review

Bonaventura

Montecucco

2018

Diabetes Research and Clinical Practice

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Section: Transient Hyperglycemia: What To Do?supporting

confidence: 56%

Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? A narrative review

Bonaventura

Montecucco

2018

Diabetes Research and Clinical Practice

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“…[ 25 ] Previous studies showed that 53–70% of individuals without diabetes develop steroid-induced hyperglycemia. [ 26 ] A meta-analysis of 13 studies showed that overall, 32.3% of people developed glucocorticoid-induced hyperglycemia and 18.6% developed diabetes. [ 27 ] In this study, 31 required steroids, of which 11 (35.5%) developed NODM after three months.…”

Section: Discussionmentioning

confidence: 99%

New onset diabetes mellitus in post-COVID-19 patients

Keerthi

Sushmita

Khan

et al. 2022

Journal of Family Medicine and Primary Care

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Background: Diabetes, is known to have a bilateral relationship with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Precise mechanism of diabetes onset in COVID-19 patients remains unclear. Aim: To analyse the incidence of new onset diabetes (NODM) among COVID-19 patients, as well as the effect of body mass index (BMI), family history, and steroid use on the incidence of the disease. Methods: Adult, not known diabetic patients, tested positive with Rapid Antigen Test or RT-PCR admitted to a tertiary care hospital and research institute were included in the present prospective observational study. The patients who developed NODM and NOPD (New Onset Pre-diabetes) during the three months follow-up and the risk factors associated were assessed. Patients with HbA1c >6.4% were diagnosed with NODM. An HbA1c of 5.7% to 6.4% was used to characterize NOPD. Results: Out of 273 previously not known diabetic COVID-19 infected individuals, a total of 100 were studied for three months after consent. Mean age of the patients 48.31 ± 19.07 years with male predominance (67%). Among these, 58% were non-diabetics and 42% were pre-diabetics. 6 (10.3%) of the 58 non-diabetics developed NOPD, and 8 (13.8%) developed NODM. 6 (14.2%) of the 42 pre-diabetics became non-diabetic, and 16.6% (7) developed NODM. Family history of DM ( P < 0.001), severity at admission ( P < 0.006), diabetic ketoacidosis ( P < 0.0275), and persistent symptoms were associated significantly with NODM. Those with NODM had significantly greater BMI, O 2 duration, steroid duration, FBS, and PPBS ( P < 0.001 for all). Nearly 67% of the patients who developed NOPD had shortness of breath as the common symptom at time of admission ( P = 0.0165). Conclusion: The incidence of NODM was strongly influenced by positive family history of DM, higher BMI, steroid dosage, and its duration. Hence, patients with COVID-19 need to be under surveillance for blood glucose screening.

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“…Steroid-induced hyperglycemia is common in hospitalized patients. Previous studies show that 53–70% of individuals without diabetes develop steroid-induced hyperglycemia ( 42 ). An Australian study of 80 hospitalized people without diabetes reported that 70% of subjects had at least one blood glucose measurement of ≥10 mmol/L ( 43 ).…”

Section: Potential Mechanisms For New-onset Diabetesmentioning

confidence: 99%

COVID-19, Hyperglycemia, and New-Onset Diabetes

et al. 2021

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Certain chronic comorbidities, including diabetes, are highly prevalent in people with coronavirus disease 2019 and are associated with an increased risk of severe COVID-19 and mortality. Mild glucose elevations are also common in COVID-19 patients and associated with worse outcomes even in people without diabetes. Several studies have recently reported new-onset diabetes associated with COVID-19. The phenomenon of new-onset diabetes following admission to the hospital has been observed previously with other viral infections and acute illnesses. The precise mechanisms for new-onset diabetes in people with COVID-19 are not known, but it is likely that a number of complex interrelated processes are involved, including previously undiagnosed diabetes, stress hyperglycemia, steroid-induced hyperglycemia, and direct or indirect effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the b-cell. There is an urgent need for research to help guide management pathways for these patients. In view of increased mortality in people with new-onset diabetes, hospital protocols should include efforts to recognize and manage acute hyperglycemia, including diabetic ketoacidosis, in people admitted to the hospital. Whether new-onset diabetes is likely to remain permanent is not known, as the long-term follow-up of these patients is limited. Prospective studies of metabolism in the setting of postacute COVID-19 will be required to understand the etiology, prognosis, and treatment opportunities.The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that results in the clinical disease coronavirus disease 2019 (COVID-19) was first reported in December 2019 Wuhan, China, and has claimed over 2 million lives globally (1). Certain chronic comorbidities, such as hypertension, cardiovascular disease, obesity, diabetes, and kidney disease, are highly prevalent in people with COVID-19. While these comorbidities do not appear to increase the risk of developing COVID-19, they are associated with an increased risk of a more severe case of the condition as well as mortality (2).

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Steroid-induced hyperglycaemia in hospitalised patients: does it matter?

Cited by 16 publications

References 10 publications

Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? A narrative review

Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? A narrative review

New onset diabetes mellitus in post-COVID-19 patients

COVID-19, Hyperglycemia, and New-Onset Diabetes

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