The high incidence of steroid-induced hyperglycaemia in hospital

Diabetes Res Clin Pract. 2013 Mar;99(3):277-80. doi: 10.1016/j.diabres.2012.12.023. Epub 2013 Jan 5.


Aim: The objective of this study was to systematically evaluate the incidence of steroid-induced hyperglycaemia in a tertiary referral hospital. We conducted a glucometric audit of a prospective protocol where glucose monitoring was routinely performed on patients treated with high-dose steroids.

Methods: The protocol specified routine fingerprick glucose monitoring for patients commencing high-dose steroid therapy (prednisone 25mg/day, dexamethasone 4 mg/day, hydrocortisone 100mg/day, or more) for a minimum of 48 h. The medical records and charts of these patients were audited after a 6 month period.

Results: There were 80 non-diabetic patients treated with high-dose steroids and 862 blood glucose (BG) readings were recorded. The mean BG was ≥8 mmol/L in 38 (48%) patients and ≥10 mmol/L in 11 (14%) subjects. Sixty-nine (86%) subjects had at least one BG ≥8 mmol/L, and 56 (70%) subjects had at least one BG ≥10 mmol/L. Among those with hyperglycaemia, it had developed within 48 h in 94% of subjects. When prednisone was administered as a once daily morning dose, glucose levels peaked in the afternoon, and would return to baseline by the next morning.

Conclusions: We conclude that steroid-induced hyperglycaemia is common in hospital. Patients should be monitored for hyperglycaemia upon commencement of high-dose steroid therapy and treatment commenced as indicated.

MeSH terms

  • Australia / epidemiology
  • Blood Glucose
  • Dexamethasone / adverse effects*
  • Hospitalization
  • Humans
  • Hydrocortisone / adverse effects*
  • Hyperglycemia / chemically induced*
  • Hyperglycemia / epidemiology
  • Incidence
  • Prednisone / adverse effects*
  • Prospective Studies


  • Blood Glucose
  • Dexamethasone
  • Prednisone
  • Hydrocortisone