Glucocorticoid-Induced Hyperglycemia: A Neglected Problem
Open accessAbstract
Glucocorticoids provide a potent therapeutic response and are widely used to treat a variety of diseases, including coronavirus disease 2019 (COVID-19) infection. However, the issue of glucocorticoid-induced hyperglycemia (GIH), which is observed in over one-third of patients treated with glucocorticoids, is often neglected. To improve the clinical course and prognosis of diseases that necessitate glucocorticoid therapy, proper management of GIH is essential. The key pathophysiology of GIH includes systemic insulin resistance, which exacerbates hepatic steatosis and visceral obesity, as well as proteolysis and lipolysis of muscle and adipose tissue, coupled with β-cell dysfunction. For patients on glucocorticoid therapy, risk stratification should be conducted through a detailed baseline evaluation, and frequent glucose monitoring is recommended to detect the onset of GIH, particularly in high-risk individuals. Patients with confirmed GIH who require treatment should follow an insulin-centered regimen that varies depending on whether they are inpatients or outpatients, as well as the type and dosage of glucocorticoid used. The ideal strategy to maintain normoglycemia while preventing hypoglycemia is to combine basal-bolus insulin and correction doses with a continuous glucose monitoring system. This review focuses on the current understanding and latest evidence concerning GIH, incorporating insights gained from the COVID-19 pandemic.
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Glucocorticoid-induced hyperglycemia affects over one-third of patients on corticosteroids.
“This results in glucocorticoid-induced hyperglycemia (GIH), which affects over one-third of patients on corticosteroids [44].”
From Thyrotoxic Hypokalemic Periodic Paralysis: Pathophysiological Mechanisms (2025) · cites this paper as [44]
The Epidemiology section reports a 34% incidence of glucocorticoid-induced hyperglycemia, but that figure comes from a study of inpatients, not all patients taking corticosteroids. The same section reports different estimates in other populations, so the broader ‘over one-third’ claim is not established by this source. (LLM, conf=0.88)
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Գլյուկոկորտիկոիդ-ասոցացված հիպերգլիկեմիայի կառավարումը օնկոլոգիական հիվանդների շրջանում
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- Authors
- Cho, J.-H., & Suh, S.
- Affiliations
- Samsung Changwon Hospital (KR)
- Corresponding author
- Suh, Sunghwan
- Venue
- Endocrinology and Metabolism
- Publisher
- Korean Endocrine Society
- Published
- 2024-04-30
- Volume
- 39
- Issue
- 2
- Pages
- 222-238
- ISSN
- 2093-596X (ISSN-L)
- 2093-5978
- PMC
- PMC11066448
- OpenAlex
- W4393229419
- Cited by
- 63
- References
- 119
- Citations by year
- 2026: 37 · 2025: 24 · 2024: 2
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Endocrinology and Metabolism (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- 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 › Diabetes Treatment and Management
- Keywords
- glucocorticoid-induced hyperglycemia, glucocorticoids, insulin resistance, hepatic steatosis, visceral obesity, beta-cell dysfunction, glucose monitoring, risk stratification, insulin therapy, multiple daily insulin injections, continuous glucose monitoring, hypoglycemia prevention, COVID-19 pandemic, glucocorticoid-induced diabetes
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Drug Treatment, Blood Glucose, Glucocorticoids, Humans, Hyperglycemia, Insulin, Insulin Resistance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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