Risk factors for steroid diabetes in rheumatic patients

Arch Med Res. Autumn 1998;29(3):259-62.

Abstract

Background: Steroid induced diabetes (SDM) has been known for a long time, but its pathophysiological mechanisms as well as its predisposing factors remain unknown.

Methods: In order to investigate the different factors related to the development of steroid diabetes (SDM) in patients with rheumatic diseases, we studied 27 patients with SDM, and 27 age- and sex-matched controls who also received therapy with glucocorticoids. In every case, family history of DM, body mass index, associated treatment, steroid dose and treatment duration were studied; fasting serum insulin, "C" peptide, growth hormone and glucagon levels were measured.

Results: All of the patients received prednisone. Cumulated prednisone dose was the only factor significantly associated with the development of SDM. Patients with SDM had a cumulated dose of 26.6 +/- 28 g (M +/- SD), while the control group received 11.6 +/- 11 g (p < 0.02) (odds ratio, 6.35). Serum insulin levels were not significantly different, but insulin/glucose ratio was lower in SDM (0.104 +/- 0.05) than in the control group (0.163 +/- 0.07) (p < 0.05).

Conclusions: These findings suggest that high cumulated prednisone dose may induce DM regardless of another hereditary or personal predisposing factor.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Diabetes Mellitus / chemically induced*
  • Female
  • Glyburide / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Prednisone / adverse effects*
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / drug therapy
  • Risk Factors

Substances

  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Hypoglycemic Agents
  • Insulin
  • Glyburide
  • Prednisone