Evaluating the nature and prevalence of glucocorticoid-induced type 2 diabetes mellitus in patients with autoimmune bullous diseases

Abstract

Glucocorticoid use in patients with autoimmune bullous disease is associated with significant morbidity, and in some cases, excess mortality. The hyperglycaemic complications arising from glucocorticoid use have been well-documented and range from mild hyperglycaemia to diabetic ketoacidosis. Patients with pre-existing glucose intolerance or type 2 diabetes mellitus are at increased risk of developing complications. Several other factors have been investigated for their association with steroid-induced hyperglycaemia, including patient age, gender, family history, dose, regimen and duration of therapy. Findings in the current literature, however, are largely conflicting and evidence is limited by methodological weaknesses. Glucocorticoids should be used with caution, and steroid-using patients should be closely monitored for adverse effects.

Corticosteroid-induced hyperglycemia

“…Glucocorticoids are very common medications in medical practice, that is, they are widely used due to their known anti-inflammatory effects, especially prescribed for patients with COPD (Chronic Obstructive Pulmonary Disease), Asthma and inflammatory respiratory diseases, inflammatory bowel disease, adrenal insufficiency, transplantation (assisting in the immunosuppression process to reduce the risk of solid organ transplant rejection), vasculitis and inflammatory vascular diseases, cancer treatment, among other very prevalent conditions (Baldwin et al, 2012;Ferrelli et al, 2014;Grommesh et al, 2016;Li et al, 2016;Johal et al, 2023). The main associated risk factors are high body mass index (BMI), presence of injuries or reduced glucose tolerance and high previous doses of corticosteroid therapy (Baldwin et al, 2012;Gerads et al, 2015;Leiter et al, 2021;van Bommel et al, 2018).…”