Hyperglycemia related to high-dose glucocorticoid use in noncritically ill patients

Gonzalez Gonzalez, Jose Gerardo y Mireles Zavala, Leonor Guadalupe y Rodríguez Gutiérrez, René y Gomez Almaguer, David y Lavalle Gonzalez, Fernando Javier y Tamez Pérez, Héctor Eloy y Gonzalez Saldivar, Gerardo y Villarreal Perez, Jesus Zacarias (2013) Hyperglycemia related to high-dose glucocorticoid use in noncritically ill patients. Diabetology & Metabolic Syndrome, 5 (1). p. 18. ISSN 1758-5996

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URL o página oficial: http://doi.org/10.1186/1758-5996-5-18

Resumen

Background: Glucocorticoids commonly cause drug-induced diabetes. This association is well recognized but available evidence does not answer clinically relevant issues in subjects without diabetes. Methods: Thirty-five individuals without diabetes with a recent diagnosis of acute lymphoblastic leukemia or nonHodgkin’s lymphoma on high-dose glucocorticoid therapy were studied. Close systematic monitoring of fasting and postprandial glycemia and fasting insulin determinations, HOMA-insulin resistance and HOMA β-cell function were performed. The primary objective was to define the incidence of secondary diabetes in patients treated with highdose glucocorticoids. Secondary objectives were to specify the intensity, the moment it appears and the evolution of hyperglycemia, in addition to the risk factors, mechanisms and impact of continuous and cyclical glucocorticoids on the development of hyperglycemia. Results: Mean age of patients was 38.4 ± 18.7 years. The incidence of diabetes was 40.6% and was found after the first week; half the time it occurred between the second and fourth. Two-thirds spontaneously normalized by eight weeks. Continuous glucocorticoid administration had a higher incidence of fasting hyperglycemia (P = 0.003). Mean peak insulin levels were significantly higher in cases of diabetes. Conclusions: High-dose prednisone for 2 to 3 months produced an elevated incidence of diabetes, usually with mild hyperglycemia occurring between the second and fourth week, normalizing spontaneously in all cases. Hyperglycemia was more frequent with continuous doses and occurred in cases with increased insulin resistance. The clinical and therapeutic characteristics of our participants, who were otherwise healthy, could represent the clinical setting of many patients with illness from other medical areas that might require high doses of GC for six to twelve weeks.

Tipo de elemento: Article
Palabras claves no controlados: Diabetes, Secondary diabetes, Glucocorticoid-induced diabetes, Glucocorticoid, Hyperglycemia, Drug-induced diabetes
Materias: R Medicina > RC Medicina Interna, Psiquiatría, Neurología
Divisiones: Medicina
Usuario depositante: Lic. Josimar Pulido
Creadores:
CreadorEmailORCID
Gonzalez Gonzalez, Jose GerardoNO ESPECIFICADONO ESPECIFICADO
Mireles Zavala, Leonor GuadalupeNO ESPECIFICADONO ESPECIFICADO
Rodríguez Gutiérrez, RenéNO ESPECIFICADONO ESPECIFICADO
Gomez Almaguer, DavidNO ESPECIFICADONO ESPECIFICADO
Lavalle Gonzalez, Fernando JavierNO ESPECIFICADONO ESPECIFICADO
Tamez Pérez, Héctor EloyNO ESPECIFICADONO ESPECIFICADO
Gonzalez Saldivar, GerardoNO ESPECIFICADONO ESPECIFICADO
Villarreal Perez, Jesus ZacariasNO ESPECIFICADONO ESPECIFICADO
Fecha del depósito: 22 Mayo 2020 17:47
Última modificación: 10 Jun 2020 17:05
URI: http://eprints.uanl.mx/id/eprint/14853

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