Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients
Abstract
Objective To investigate the prevalence of and risk factors for hyperglycemia in hospitalized patients receiving corticosteroids, which have been identified as an independent predictor of hyperglycemia.Methods We conducted a retrospective review of electronic medical records of patients admitted to the general medicine service at a university hospital during a 1-month period. Pharmacy charges were used to identify patients receiving high doses (> or = 40 mg/day of prednisone or the equivalent) of corticosteroids for at least 2 days. Occurrence of hyperglycemia and the presence of risk factors, including history of diabetes, duration of corticosteroid therapy, concurrent parenteral nutrition, antibiotic therapy, use of medications associated with hyperglycemia, severity of illness scores, and hospital length of stay, were determined. Patients experiencing multiple episodes of hyperglycemia (glucose levels > or = 200 mg/dL) were compared with those who had < or = 1 hyperglycemic episode. Patients without a history of diabetes were assessed separately.Results During the 1-month study period, 66 of 617 patients received high doses of corticosteroids, but only 50 of the 66 had glucose measurements. Hyperglycemia was documented in 32 of these 50 patients (64%), and multiple hyperglycemic episodes occurred in 26 (52%). A history of diabetes was documented in 12 of 26 patients who experienced multiple episodes, in comparison with 4 of 24 patients with < or = 1 episode of hyperglycemia (P = 0.035). Among patients without a history of diabetes, 19 of 34 (56%) had hyperglycemia at least once. Patients with multiple episodes of hyperglycemia had more comorbid diseases, longer duration of corticosteroid therapy, and longer duration of hospital stay.Conclusion Hyperglycemia occurs in a majority of hospitalized patients receiving high doses of corticosteroids. In light of the poor outcomes associated with hyperglycemia, protocols targeting its detection and management should be available for patients who receive corticosteroid therapy.
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The risk of diabetes was greater in subjects with abdominal adiposity or genetic predisposition and in those taking higher doses of glucocorticoids for longer periods.
“The risk of DM was greater in subjects with abdominal adiposity or a genetic predisposition to DM and in those taking higher doses of GCs and for longer periods (, -).”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [198]
Glucocorticoids adversely affect glucose homeostasis, including insulin resistance, visceral adiposity, dyslipidaemia, and fasting and postprandial hyperglycaemia.
“their usage is associated with a significant number of metabolic adverse effects, including insulin resistance, visceral adiposity, dyslipidaemia and fasting and postprandial hyperglycaemia.2”
From Twenty‐four‐hour profiles of plasma glucose, insulin, C‐peptide and free fatty acid in subjects with varying degrees of glucose tolerance following short‐term, medium‐dose prednisone (20 mg/day) treatment: evidence for differing effects on insulin secretion and action (2012) · cites this paper as [2]
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- Authors
- Donihi, A. C., Raval, D., Saul, M., Korytkowski, M. T., & DeVita, M. A.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Donihi, Amy Calabrese
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2006-07
- Volume
- 12
- Issue
- 4
- Pages
- 358-362
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W1977503469
- Cited by
- 246
- References
- 13
- Citations by year
- 2026: 4 · 2025: 16 · 2024: 13 · 2023: 16 · 2022: 18 · 2021: 15 · 2020: 15 · 2019: 13 · 2018: 21 · 2017: 14 · 2016: 12 · 2015: 15 · 2014: 15 · 2013: 22 · 2012: 13
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- Eli Lilly and Company
- Novo Nordisk
- Medical Center, University of Pittsburgh
- 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
- corticosteroid-induced hyperglycemia, hospitalized patients, prednisone, risk factors, prevalence, history of diabetes, length of hospital stay, comorbidities, medical inpatients
- MeSH terms
- Adrenal Cortex Hormones, Adult, Aged, Female, Hospitalization, Humans, Hyperglycemia, Male, Middle Aged, Retrospective Studies, Risk Factors, Comorbidity, Prevalence, Diabetes Complications
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