Steroid-induced diabetes: a clinical and molecular approach to understanding and treatment

Diabetes Metab Res Rev. 2014 Feb;30(2):96-102. doi: 10.1002/dmrr.2486.


Since the advent of glucocorticoid therapy for autoimmune disease in the 1940s, their widespread application has led to the concurrent therapy-limiting discovery of many adverse metabolic side effects. Unanticipated hyperglycemia associated with the initiation of glucocorticoids often leads to preventable hospital admissions, prolonged hospital stays, increased risks for infection and reduced graft function in solid organ transplant recipients. Challenges in managing steroid-induced diabetes stem from wide fluctuations in post-prandial hyperglycemia and the lack of clearly defined treatment protocols. The mainstay of treatment is insulin therapy coincident with meals. This article aims to review the pathogenesis, risk factors, diagnosis and treatment principles unique to steroid-induced diabetes.

Keywords: glucocorticoids; insulin resistance; new onset diabetes after transplant; steroid-induced diabetes.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / drug effects*
  • Adipose Tissue / metabolism
  • Carbohydrate Metabolism / drug effects
  • Congresses as Topic
  • Diabetes Mellitus / chemically induced*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / therapy
  • Glucocorticoids / adverse effects
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Lipid Metabolism / drug effects
  • Liver / drug effects*
  • Liver / metabolism
  • Models, Biological*
  • Risk Factors
  • Steroids / adverse effects*


  • Glucocorticoids
  • Immunosuppressive Agents
  • Steroids