Cited by 508Hyperglycemia and glycemic control in critically ill and hospitalized patientsAdrenal Hormones and DisordersDiabetes Treatment and Management

Glucocorticoid-induced hyperglycemia

Clore, John N., Thurby-Hay, Linda·2009·Endocrine Practice

Abstract

Objective To review the current literature on glucocorticoid-induced hyperglycemia and provide a strategy for its treatment.Methods We undertook an electronic (MEDLINE) and a library review of the existing pertinent literature published from 1950 to March 2009.Results Glucocorticoid-induced hyperglycemia is common in patients with and without diabetes. The odds ratio for new-onset diabetes mellitus in patients treated with glucocorticoids ranges from approximately 1.5 to 2.5. Total glucocorticoid dose and duration of therapy are strong predictors of diabetes induction. Other risk factors include age and body mass index. Failure to treat glucocorticoid-induced hyperglycemia is related to the presumed short duration of administration of glucocorticoid treatment and the emphasis on fasting plasma glucose only. Understanding the pharmacodynamics of glucocorticoids can lead to increased recognition and improved treatment of the condition. Recent demonstrations that even shortterm elevations in blood glucose level may be associated with adverse sequelae argue for greater attention to the condition.Conclusion Glucocorticoid-induced hyperglycemia is an important clinical finding that, if recognized, can be effectively treated. We propose a relatively simple schema for the proactive management of corticosteroid-induced hyperglycemia that has been effective and easily adaptable to both the inpatient and the outpatient setting.

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Crossref · 10.4158/ep08331.rar

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  • This observation is in line with previous studies reporting large postprandial glucose excursions with only modest changes in fasting glucose levels.

    “This observation is in line with previous studies reporting large postprandial glucose excursions with only modest changes in fasting glucose levels [19, 26].”
  • Patients with long-term cortisol excess, as seen in Cushing syndrome, and patients treated with glucocorticoids often have increased susceptibility to hyperglycaemia and manifest diabetes mellitus.

    “Patients with long-term cortisol excess, as seen in those with Cushing syndrome 24 , and patients treated with glucocorticoids often have increased susceptibility to hyperglycaemia and manifest diabetes mellitus 25 .”
  • Glucocorticoid-induced hyperglycemia or diabetes is a common complication.

    “GC-induced hyperglycemia or DM is nonetheless a common complication (-), and there are reports of a dose-dependent increase in the risk of developing DM requiring hypoglycemic therapy ().”
  • A recent meta-analysis found an odds ratio of 1.5 to 2.5 for newly diagnosed diabetes in patients taking exogenous glucocorticoids.

    “A recent meta-analysis revealed an odds ratio of . to . for newly diagnosed DM in patients taking exogenous GCs; measuring FPG level may underestimate the disease compared with a glucose tolerance test ().”
  • Measuring fasting plasma glucose may underestimate diabetes compared with a glucose tolerance test.

    “A recent meta-analysis revealed an odds ratio of . to . for newly diagnosed DM in patients taking exogenous GCs; measuring FPG level may underestimate the disease compared with a glucose tolerance test ().”

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Authors
Clore, J. N., & Thurby-Hay, L.
Affiliations
Virginia Commonwealth University (US)
Corresponding author
Clore, John N.
Venue
Endocrine Practice
Publisher
Elsevier BV
Published
2009-07
Volume
15
Issue
5
Pages
469-474
ISSN
1530-891X (ISSN-L)
OpenAlex
W2057624928
Cited by
508
References
39
Citations by year
2026: 34 · 2025: 29 · 2024: 32 · 2023: 40 · 2022: 37 · 2021: 46 · 2020: 29 · 2019: 34 · 2018: 31 · 2017: 26 · 2016: 19 · 2015: 25 · 2014: 22 · 2013: 33 · 2012: 26
FWCI
3.11
Type
journal article
Language
en
Open access
closed
Locations
  • Endocrine 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 › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
glucocorticoid-induced hyperglycemia, corticosteroid-induced diabetes, new-onset diabetes, risk factors, fasting blood glucose, hyperglycemia management, body mass index, age
MeSH terms
Glucocorticoids, Humans, Hyperglycemia

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