Management of steroid-induced hyperglycemia in hospitalized patients with cancer: a review
Abstract
PROBLEM IDENTIFICATION: Glucocorticoids are prescribed for hospitalized patients with cancer for a variety of reasons, including cerebral edema, treatment and prevention of nausea, and as part of cancer treatment regimens. Glucocorticoids are known to cause hyperglycemia. The purpose of this study was to integrate the published research on the management and the effects of steroid-induced hyperglycemia in hospitalized adult patients with cancer with or without preexisting diabetes. LITERATURE SEARCH: MEDLINE®, PubMed, EMBASE, CINAHL®, and Scopus electronic databases were used to identify relevant articles. Bibliographies of included studies were reviewed for any pertinent studies that were not obtained through database search.Data Evaluation: 1,392 studies were identified. A total of 18 studies that met criteria were fully reviewed, 6 of which met all of the inclusion criteria. DATA ANALYSIS: Data were abstracted from the included studies using a systematic code sheet to document characteristics of the studies and findings on management of hyperglycemia. Characteristics of the studies and findings on management of hyperglycemia were organized into three tables: the patients did not have preexisting diabetes, the patients had preexisting diabetes, and patients with or without preexisting diabetes were both included in the study. Management and effects of management of hyperglycemia were then compared and synthesized.Presentation of Findings: Hyperglycemia occurs in hospitalized patients with cancer irrespective of whether patients have a prior history of diabetes. Hyperglycemia resulting from steroids is treated in a variety of ways, but the resulting glycemic control has not been consistently documented. However, this review suggests that scheduled insulin (basal-bolus) is effective in attainment of glucose targets. IMPLICATIONS FOR PRACTICE: Nurses should be aware of the effect that steroids have on glycemic control in patients and should be empowered to request or perform blood glucose monitoring when appropriate. Nurses can identify those patients receiving steroids and assess for signs and symptoms of hyperglycemia. They also can review routine laboratory results and assess for hyperglycemia in patients receiving steroids.
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Previous reports show afternoon and evening hyperglycaemia under glucocorticoids in persons without diabetes mellitus.
“These findings are in line with previous reports of afternoon and evening hyperglycaemia under glucocorticoids in persons without DM.24 27 55”
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- Authors
- Brady, V. J., Grimes, D., Armstrong, T., & LoBiondo-Wood, G.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- The University of Texas Health Science Center at Houston (US)
- Venue
- Oncology nursing forum
- Publisher
- Oncology Nursing Society (ONS)
- Published
- 2014-10-29
- Volume
- 41
- Issue
- 6
- Pages
- E355-E365
- ISSN
- 0190-535X (ISSN-L)
- 1538-0688
- OpenAlex
- W1989365309
- Cited by
- 31
- References
- 31
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 6 · 2018: 2 · 2017: 3 · 2016: 2 · 2015: 1
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Oncology nursing forum (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 › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- steroid-induced hyperglycemia, glucocorticoids, cancer patients, hospitalized patients, pregestational diabetes, glycemic control, multiple daily insulin injections, blood glucose monitoring, nursing role, hyperglycemia management
- MeSH terms
- Glucocorticoids, Hospitalization, Humans, Hyperglycemia, Neoplasms, Diabetes Complications
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