Cited by 216Pancreatic function and diabetesDiabetes Treatment and ManagementAdrenal Hormones and Disorders

Glucocorticoid treatment and endocrine pancreas function: implications for glucose homeostasis, insulin resistance and diabetes

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Rafacho, Alex, Ortsäter, Henrik, Nadal, Angel, Quesada, Ivan·2014·Journal of Endocrinology

Abstract

Glucocorticoids (GCs) are broadly prescribed for numerous pathological conditions because of their anti-inflammatory, antiallergic and immunosuppressive effects, among other actions. Nevertheless, GCs can produce undesired diabetogenic side effects through interactions with the regulation of glucose homeostasis. Under conditions of excess and/or long-term treatment, GCs can induce peripheral insulin resistance (IR) by impairing insulin signalling, which results in reduced glucose disposal and augmented endogenous glucose production. In addition, GCs can promote abdominal obesity, elevate plasma fatty acids and triglycerides, and suppress osteocalcin synthesis in bone tissue. In response to GC-induced peripheral IR and in an attempt to maintain normoglycaemia, pancreatic β-cells undergo several morphofunctional adaptations that result in hyperinsulinaemia. Failure of β-cells to compensate for this situation favours glucose homeostasis disruption, which can result in hyperglycaemia, particularly in susceptible individuals. GC treatment does not only alter pancreatic β-cell function but also affect them by their actions that can lead to hyperglucagonaemia, further contributing to glucose homeostasis imbalance and hyperglycaemia. In addition, the release of other islet hormones, such as somatostatin, amylin and ghrelin, is also affected by GC administration. These undesired GC actions merit further consideration for the design of improved GC therapies without diabetogenic effects. In summary, in this review, we consider the implication of GC treatment on peripheral IR, islet function and glucose homeostasis.

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Research works printed but not linked: 2

  1. Ottosson M, Vikman-Adolfsson K, Enerba ¨ck S, Olivecrona G & Bjo ¨rntorp P 1994 The effects of cortisol on the regulation of lipoprotein lipase activity in adipose tissue. Journal of Clinical Endocrinology 79 820-825.
  2. Stojanovska L, Rosella G & Proietto J 1990 Evolution of dexamethasone- induced insulin resistance in rats. American Journal of Physiology 258 E748-E756.

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Authors
Rafacho, A., Ortsäter, H., Nadal, A., & Quesada, I.
Affiliations
Universitat de Miguel Hernández d'Elx (ES)
Venue
Journal of Endocrinology
Published
2014-09-30
Volume
223
Issue
3
Pages
R49-R62
ISSN
  • 0022-0795 (ISSN-L)
  • 1479-6805
OpenAlex
W2170071103
Cited by
216
References
124
Citations by year
2026: 7 · 2025: 11 · 2024: 21 · 2023: 14 · 2022: 19 · 2021: 18 · 2020: 18 · 2019: 27 · 2018: 27 · 2017: 16 · 2016: 22 · 2015: 15 · 2014: 1
FWCI
3.40
Type
journal article
Language
en
Open access
Locations
  • Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-nd)
Funders
  • European Foundation for the Study of Diabetes
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (471397/2011-3)
  • Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas
  • Instituto de Salud Carlos III
Topics
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
glucocorticoids, diabetogenic effect, glucose homeostasis, insulin resistance, beta-cell function, hyperinsulinemia, hyperglycemia, hyperglucagonaemia, islet hormones, somatostatin, amylin, ghrelin, osteocalcin, abdominal obesity, insulin signaling
MeSH terms
Animals, Blood Glucose, Diabetes Mellitus, Type 2, Glucocorticoids, Glucose, Homeostasis, Humans, Insulin Resistance, Islets of Langerhans, Models, Biological

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