The high incidence of steroid-induced hyperglycaemia in hospital
Abstract
Aim The objective of this study was to systematically evaluate the incidence of steroid-induced hyperglycaemia in a tertiary referral hospital. We conducted a glucometric audit of a prospective protocol where glucose monitoring was routinely performed on patients treated with high-dose steroids.Methods The protocol specified routine fingerprick glucose monitoring for patients commencing high-dose steroid therapy (prednisone 25mg/day, dexamethasone 4 mg/day, hydrocortisone 100mg/day, or more) for a minimum of 48 h. The medical records and charts of these patients were audited after a 6 month period.Results There were 80 non-diabetic patients treated with high-dose steroids and 862 blood glucose (BG) readings were recorded. The mean BG was ≥8 mmol/L in 38 (48%) patients and ≥10 mmol/L in 11 (14%) subjects. Sixty-nine (86%) subjects had at least one BG ≥8 mmol/L, and 56 (70%) subjects had at least one BG ≥10 mmol/L. Among those with hyperglycaemia, it had developed within 48 h in 94% of subjects. When prednisone was administered as a once daily morning dose, glucose levels peaked in the afternoon, and would return to baseline by the next morning.Conclusions We conclude that steroid-induced hyperglycaemia is common in hospital. Patients should be monitored for hyperglycaemia upon commencement of high-dose steroid therapy and treatment commenced as indicated.
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Over half of patients receiving high-dose steroids develop hyperglycaemia.
“Over half of patients receiving high-dose steroids develop hyperglycaemia.10”
Cites
Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes
Umpierrez, G. E., Isaacs, S. D., Bazargan, N., You, X., Thaler, L. M., & Kitabchi, A. E. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8341 · Cited by 2,195 · see citing works
Capes, S. E., Hunt, D., Malmberg, K., & Gerstein, H. C. (2000) · The Lancet · doi:10.1016/s0140-6736(99)08415-9 · Cited by 2,187 · cited 2× · see citing works
“[1] Capes SE, Hunt D, Malmberg K, Gerstein HC.”
BackgroundCapes, S. E., Hunt, D., Malmberg, K., Pathak, P., & Gerstein, H. C. (2001) · Stroke · doi:10.1161/hs1001.096194 · Cited by 1,824 · see citing works
Umpierrez, G. E., Hellman, R., Korytkowski, M. T., Kosiborod, M., Maynard, G. A., Montori, V. M., Seley, J. J., & Van den Berghe, G. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2098 · Cited by 1,126 · see citing works
Glucose Control and Mortality in Critically Ill Patients
Finney, S. J. (2003) · JAMA · doi:10.1001/jama.290.15.2041 · Cited by 1,037 · see citing works
Glucose Control Lowers the Risk of Wound Infection in Diabetics After Open Heart Operations
Zerr, K. J., Furnary, A. P., Grunkemeier, G. L., Bookin, S. O., Kanhere, V. M., & STARR, A. M. (1997) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(96)01044-2 · Cited by 908 · see citing works
RIZZA, R. A., MANDARINO, L. J., & GERICH, J. E. (1982) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-54-1-131 · Cited by 696 · cited 2× · see citing works
“This is not a surprising finding given the recognised association between age and insulin resistance and reduced insulin secretory capacity, both of which are also factors in the development of steroid-induced hyperglycaemia [17,18].”
BackgroundGolden, S. H., Peart-Vigilance, C., Kao, W. H. L., & Brancati, F. L. (1999) · Diabetes Care · doi:10.2337/diacare.22.9.1408 · Cited by 548 · see citing works
Glucocorticoid-induced hyperglycemia
Clore, J. N., & Thurby-Hay, L. (2009) · Endocrine Practice · doi:10.4158/ep08331.rar · Cited by 508 · see citing works
Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients
Donihi, A. C., Raval, D., Saul, M., Korytkowski, M. T., & DeVita, M. A. (2006) · Endocrine Practice · doi:10.4158/ep.12.4.358 · Cited by 246 · see citing works
Hyperglycemia Is Associated With Adverse Outcomes in Patients Receiving Total Parenteral Nutrition
Cheung, N. W., Napier, B., Zaccaria, C., & Fletcher, J. (2005) · Diabetes Care · doi:10.2337/diacare.28.10.2367 · Cited by 221 · see citing works
Self-citationContinuous monitoring of circadian glycemic patterns in patients receiving prednisolone for COPD
Burt, M. G., Roberts, G. W., Aguilar-Loza, N. R., Frith, P., & Stranks, S. N. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2729 · Cited by 203 · see citing works
Glycemic Control in Non-Critically Ill Hospitalized Patients: A Systematic Review and Meta-Analysis
Murad, M. H., Coburn, J. A., Yglesias, F. C., Dzyubak, S., Hazem, A., Lane, M. A., Prokop, L. J., & Montori, V. M. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2100 · Cited by 192 · see citing works
Alford, F., Beck-Nielsen, H., Ward, G. M., & Henriksen, J. E. (1997) · Diabetologia · doi:10.1007/s001250050847 · Cited by 115 · see citing works
Matsumoto, K., Yamasaki, H., Akazawa, S., Sakamaki, H., Ishibashi, M., Abiru, N., Uotani, S., Matsuo, H., Yamaguchi, Y., Tokuyama, K., et al. (1996) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jcem.81.7.8675587 · Cited by 109 · see citing works
Insulin resistance induced by hydrocortisone is increased in patients with abdominal obesity
Darmon, P., Dadoun, F., Boullu-Ciocca, S., Grino, M., Alessi, M.-C., & Dutour, A. (2006) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00654.2005 · Cited by 59 · see citing works
The relationship between admission blood glucose levels and hospital mortality
Cheung, N. W., Li, S., Ma, G., & Crampton, R. (2008) · Diabetologia · doi:10.1007/s00125-008-1001-4 · Cited by 47 · see citing works
Self-citationInsulin Management of Diabetic Patients on General Medical and Surgical Floors
Leahy, J. L. (2006) · Endocrine Practice · doi:10.4158/ep.12.s3.86 · Cited by 35 · see citing works
Cheung, N. W., Cinnadaio, N., O’Neill, A., Koller, L. J., Pratt, H., Zingle, C., & Chipps, D. R. (2011) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2011.02.019 · Cited by 10 · see citing works
Self-citation
Flagged first, then by citations
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Sorted by citations
Tamez-Pérez, H. E. (2015) · World Journal of Diabetes · doi:10.4239/wjd.v6.i8.1073 · Cited by 387 · see citing works
Korytkowski, M. T., Muniyappa, R., Antinori-Lent, K., Donihi, A. C., Drincic, A. T., Hirsch, I. B., Luger, A., McDonnell, M. E., Murad, M. H., Nielsen, C., et al. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac278 · Cited by 315 · see citing works
A practical guide for the management of steroid induced hyperglycaemia in the hospital
Aberer, F., Hochfellner, D. A., Sourij, H., & Mader, J. K. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10102154 · Cited by 110 · see citing works
Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? A narrative review
Bonaventura, A., & Montecucco, F. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.03.006 · Cited by 108 · see citing works
The impact of glucocorticoids and statins on sleep quality
Szmyd, B., Rogut, M., Białasiewicz, P., & Gabryelska, A. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101380 · Cited by 66 · see citing works
Glucocorticoid-Induced Hyperglycemia: A Neglected Problem
Cho, J.-H., & Suh, S. (2024) · Endocrinology and Metabolism · doi:10.3803/enm.2024.1951 · Cited by 63 · see citing works
Tatalovic, M., Lehmann, R., Cheetham, M., Nowak, A., Battegay, E., & Rampini, S. K. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-028914 · Cited by 27 · see citing works
“Over half of patients receiving high-dose steroids develop hyperglycaemia.(10) Significantly, steroids exacerbate hyperglycaemia in patients with pre-existing DM(11) 12 and enhance the likelihood of complications, length of stay and mortality in these patients.”
Background
- Authors
- Fong, A. C., & Cheung, N. W.
- Affiliations
- Westmead Hospital (AU)
- The University of Sydney (AU)
- Corresponding author
- Cheung, N Wah.
- ORCID
- Cheung, N Wah.
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 99
- Issue
- 3
- Pages
- 277-280
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W1976238764
- Cited by
- 109
- References
- 19
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 14 · 2023: 11 · 2022: 14 · 2021: 16 · 2020: 3 · 2019: 6 · 2018: 9 · 2017: 2 · 2016: 7 · 2015: 2 · 2014: 1 · 2013: 2
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Research and Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- high-dose corticosteroids, prednisone, dexamethasone, cortisol, blood glucose monitoring, incidence, non-diabetic patients, hospitalized patients
- MeSH terms
- Australia, Blood Glucose, Dexamethasone, Hospitalization, Humans, Hydrocortisone, Hyperglycemia, Prednisone, Prospective Studies, Incidence
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