Development of a novel algorithm for detecting glucocorticoid-induced diabetes mellitus using a medical information database

Imatoh, Takuya; Sai, Kimie; Hori, Kazuyuki; Segawa, Katsunori; Kawakami, Junichi; Kimura, Michio; Saito, Yoshiro

doi:10.1111/jcpt.12499

Cited by 9 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, we found only one out of 43 patients (2.3%) with glucocorticoid-induced diabetes mellitus. The frequency of glucocorticoid-induced diabetes mellitus in the present study was apparently lower than in a survey in Japan, which reported an incidence of approximately 6%-9% [27].…”

Section: Discussioncontrasting

confidence: 50%

Complications of Short-Course Oral Corticosteroids for Eosinophilic Chronic Rhinosinusitis during Long-Term Follow-Up

Motegi¹,

S²,

Homma³

et al. 2018

Sinusitis

View full text Add to dashboard Cite

Abstract:The literature strongly recommends the use of oral corticosteroids in the management of patients with eosinophilic chronic rhinosinusitis (CRS) with nasal polyps. Although potential complications associated with the long-term use of oral corticosteroids for the treatment of CRS have been suggested, no studies have described these effects in detail. Forty-three patients with a mean age of 51 years with eosinophilic CRS were retrospectively evaluated after surgery. Short-course oral prednisolone (PSL, 0.5 mg/kg of body weight) was provided for one week when anosmia and eosinophilic mucin and/or nasal polyps were present. The postoperative follow-up period ranged from 12 to 108 months (average: 62 months). HbA1C showed normal ranges in all except one patient, who had a diabetic pattern of HbA1C of 6.5%. Five patients had serum cortisol levels below the cutoff value. However, re-examination of the serum cortisol and adrenocorticotropic hormone stimulation test showed normal ranges in all five patients who had initially shown abnormal values of serum cortisol. Thus, adrenal insufficiency in all the patients was negligible. Five (3 women and 2 men) out of the 15 patients (6 women and 9 men) who participated in bone mineral density measurement showed significant reductions, suggesting the presence of osteoporosis. Patients taking long-term and repeated short-course use of oral corticosteroids for refractory nasal polyps of eosinophilic CRS are likely to have a potentially increased risk for osteoporosis.

show abstract

Section: Discussioncontrasting

confidence: 50%

Complications of Short-Course Oral Corticosteroids for Eosinophilic Chronic Rhinosinusitis during Long-Term Follow-Up

Motegi¹,

S²,

Homma³

et al. 2018

Sinusitis

View full text Add to dashboard Cite

show abstract

“…HbA1c may be a suitable method for diagnosis in patients treated with corticosteroids for >2 months, but it is not useful for patients whose treatment has been initiated more recently. Recently, Japanese scientists developed a detection algorithm for GIDM and suggested that monitoring changes in HbA1c levels is important for detecting GIDM [33]. In patients where HbA1c levels could be unreliable, such as those with hemoglobinopathies, renal failure, or anemia/recent blood transfusion, fructosamine measurements would be a better alternative [5].…”

Section: Definition and Diagnosismentioning

confidence: 99%

Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem

2017

View full text Add to dashboard Cite

Glucocorticoids are widely used as potent anti-inflammatory and immunosuppressive drugs to treat a wide range of diseases. However, they are also associated with a number of side effects, including new-onset hyperglycemia in patients without a history of diabetes mellitus (DM) or severely uncontrolled hyperglycemia in patients with known DM. Glucocorticoid-induced diabetes mellitus (GIDM) is a common and potentially harmful problem in clinical practice, affecting almost all medical specialties, but is often difficult to detect in clinical settings. However, scientific evidence is lacking regarding the effects of GIDM, as well as strategies for prevention and treatment. Similarly to nonsteroid-related DM, the principles of early detection and risk factor modification apply. Screening for GIDM should be considered in all patients treated with medium to high doses of glucocorticoids. Challenges in the management of GIDM stem from wide fluctuations in postprandial hyperglycemia and the lack of clearly defined treatment protocols. Together with lifestyle measures, hypoglycemic drugs with insulin-sensitizing effects are indicated. However, insulin therapy is often unavoidable, to the point that insulin can be considered the drug of choice. The treatment of GIDM should take into account the degree and pattern of hyperglycemia, as well as the type, dose, and schedule of glucocorticoid used. Moreover, it is essential to instruct the patient and/or the patient's family about how to perform the necessary adjustments. Prospective studies are needed to answer the remaining questions regarding GIDM.

show abstract

“…Growing data in the genomics and metabolomics fields of research provided evidence that occurring of particular SNPs (single nucleotide polymorphisms) and particular amino acids in the baseline plasma metabolite level can be associated with the increased risk for drug-induced diabetes [6]. On the other hand, particular drug classes, e.g., glucocorticosteroids, statins, diuretics and beta-blockers [3, 4] may induce diabetes type 2 more frequently than the other drug classes due to their influence on the hepatic glucose production, pancreatic insulin secretion and peripheral tissues insulin sensitivity [7]. The complex molecular mechanism of drug-induced T2DM varies from one drug class to another (e.g.…”

Section: Introductionmentioning

confidence: 99%

Drug-induced diabetes type 2: In silico study involving class B GPCRs

et al. 2019

View full text Add to dashboard Cite

A disturbance of glucose homeostasis leading to type 2 diabetes mellitus (T2DM) is one of the severe side effects that may occur during a prolonged use of many drugs currently available on the market. In this manuscript we describe the most common cases of drug-induced T2DM, discuss available pharmacotherapies and propose new ones. Among various pharmacotherapies of T2DM, incretin therapies have recently focused attention due to the newly determined crystal structure of incretin hormone receptor GLP1R. Incretin hormone receptors: GLP1R and GIPR together with the glucagon receptor GCGR regulate food intake and insulin and glucose secretion. Our study showed that incretin hormone receptors, named also gut hormone receptors as they are expressed in the gastrointestinal tract, could potentially act as unintended targets (off-targets) for orally administrated drugs. Such off-target interactions, depending on their effect on the receptor (stimulation or inhibition), could be beneficial, like in the case of incretin mimetics, or unwanted if they cause, e.g., decreased insulin secretion. In this in silico study we examined which well-known pharmaceuticals could potentially interact with gut hormone receptors in the off-target way. We observed that drugs with the strongest binding affinity for gut hormone receptors were also reported in the medical information resources as the least disturbing the glucose homeostasis among all drugs in their class. We suggested that those strongly binding molecules could potentially stimulate GIPR and GLP1R and/or inhibit GCGR which could lead to increased insulin secretion and decreased hepatic glucose production. Such positive effect on the glucose homeostasis could compensate for other, adverse effects of pharmacotherapy which lead to drug-induced T2DM. In addition, we also described several top hits as potential substitutes of peptidic incretin mimetics which were discovered in the drug repositioning screen using gut hormone receptors structures against the ZINC15 compounds subset.

show abstract

Development of a novel algorithm for detecting glucocorticoid-induced diabetes mellitus using a medical information database

Cited by 9 publications

References 29 publications

Complications of Short-Course Oral Corticosteroids for Eosinophilic Chronic Rhinosinusitis during Long-Term Follow-Up

Complications of Short-Course Oral Corticosteroids for Eosinophilic Chronic Rhinosinusitis during Long-Term Follow-Up

Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem

Drug-induced diabetes type 2: In silico study involving class B GPCRs

Contact Info

Product

Resources

About