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Incidence and Risk Factors of Steroid-induced Diabetes in Patients with Respiratory Disease

2011; Korean Academy of Medical Sciences; Volume: 26; Issue: 2 Linguagem: Inglês

10.3346/jkms.2011.26.2.264

1598-6357

Seo Yun Kim, Chul‐Gyu Yoo, Chun Taeg Lee, Hee Soon Chung, Young Whan Kim, Sung Koo Han, Young-Soo Shim, Jae‐Joon Yim,

Diabetes Management and Research

Incidence and Risk Factors of Steroid-induced Diabetes in Patients with Respiratory DiseaseGlucocorticoids are effective for treating several respiratory diseases.However, they can cause hyperglycemia.This study determined the incidence and risk factors of steroidinduced diabetes mellitus (S-DM) in patients treated with glucocorticoid for respiratory diseases.A retrospective study examined patients with respiratory diseases treated with a prednisolone-equivalent glucocorticoid dose exceeding 20 mg/day for at least 4 weeks between January 2003 and December 2008.Patients whose initial random glucose level exceeded 200 mg/dL or who had pre-existing diabetes were excluded.S-DM was defined as a fasting glucose concentration exceeding 126 mg/dL or a random glucose concentration exceeding 200 mg/dL at least twice after beginning steroid treatment.A total of 231 patients with respiratory diseases met the inclusion criteria.Their median age was 55 yr, and 139 were female.The median cumulative prednisolone-equivalent glucocorticoid dose was 4,965 mg, and the median duration of steroid treatment was 193 days.S-DM was diagnosed in 34 (14.7%) of 231 patients.Multivariate logistic regression identified older age (odds ratio 1.05, 95% confidence interval 1.02-1.09)as a risk factor for S-DM.S-DM is frequent among patients with respiratory diseases treated with glucocorticoid.Clinicians should be aware of the possibility of S-DM, especially among elderly patients.