Glucocorticoid-induced diabetes mellitus in patients with systemic lupus erythematosus treated with high-dose glucocorticoid therapy

Ha, You Jung; Lee, Ki Hoon; Jung, Sunyo; Lee, S. W.; Park, Y. B.

doi:10.1177/0961203311402246

Cited by 62 publications

(51 citation statements)

References 41 publications

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“…One study was excluded due to the use of low-dose hydrocortisone which may have resulted in the observed very low rate of hyperglycemia (1/45; 2.2%) [12]. Thirteen studies were included in the meta-analysis [2,3,13,14,15,16,17,18,19,20,21,22,23]. …”

Section: Resultsmentioning

confidence: 99%

“…The studies investigated the effect of glucocorticoid treatment in a variety of diseases including acute lymphoblastic leukemia [3], non-Hodgkin lymphoma [3], pemphigus, mucous membrane pemphigoid [14], noninfectious ocular inflammation [15], inflammatory rheumatologic disease [12,16,21], systemic lupus erythematosus [17], respiratory disease [18], primary renal disease [19], and neurological disease [22]. One study investigated hospitalized patients [2], another assessed patients receiving palliative care [20], and one did not specify its patient population [23] (table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Nine of the studies included in our analysis were retrospective in design [2,13,15,17,18,19,20,21,22], 2 were cross-sectional studies [14,16], and 2 were either observational [3] or cohort [23] studies. The majority of the studies administered prednisone or methylprednisolone and some also administered deflazacort [13,21], dexamethasone [2,20], or hydrocortisone [2].…”

Section: Discussionmentioning

confidence: 99%

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Hyperglycemia Induced by Glucocorticoids in Nondiabetic Patients: A Meta-Analysis

et al. 2014

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Background/Aims: Glucocorticoids are associated with a number of side effects including the development of new-onset hyperglycemia or diabetes. The diagnosis and treatment of glucocorticoid-induced hyperglycemia are surprisingly undervalued by many health-care professionals, probably due to the lack of quality studies that assess specific reasons for and prevention of hyperglycemia. The aim of this meta-analysis was to evaluate the long-term incidence of glucocorticoid-induced hyperglycemia and diabetes in nondiabetic patients who received glucocorticoid treatment. Methods: We searched Medline, Embase, and the Cochrane Library (Central) until January 2014 for studies in which subjects received systematic glucocorticoid treatment and which evaluated whether subjects developed hyperglycemia or were diagnosed with diabetes following treatment. The primary outcome for this analysis was the incidence of hyperglycemia and the secondary outcome was the frequency of diabetes. Results: We identified 13 studies that met our inclusion criteria; 12 of the studies were retrospective or observational in design. We found that the rate at which patients developed glucocorticoid-induced hyperglycemia or diabetes was 32.3% (p = 0.003) and 18.6% (p = 0.002), respectively. Conclusions: Our meta-analysis indicated that glucocorticoid-induced hyperglycemia occurs fairly frequently and points to the need for the design of prospective, randomized, controlled studies to further investigate and better understand this medical problem.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hyperglycemia Induced by Glucocorticoids in Nondiabetic Patients: A Meta-Analysis

et al. 2014

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“…Moreover, 7/19 of GCA patients on high-dose GCs developed DM, and a further 2/19 developed glucose intolerance [ 43 ]. High-dose GCs induced DM in 16/127 of patients with SLE [ 79 ].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

The Prediction and Monitoring of Toxicity Associated with Long-Term Systemic Glucocorticoid Therapy

et al. 2015

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Glucocorticoids are often required for adequate control of inflammation in many serious inflammatory diseases; common indications for long-term treatment include polymyalgia rheumatica, giant cell arteritis, asthma and chronic obstructive pulmonary disease. Long-term glucocorticoid therapy is, however, associated with many adverse effects involving skin, gastrointestinal, eye, skeletal muscle, bone, adrenal, cardio-metabolic and neuropsychiatric systems. This balance between benefits and risks of glucocorticoids is important for clinical practice and glucocorticoid-related adverse effects can significantly impair health-related quality of life. Understanding the nature and mechanisms of glucocorticoid-related adverse effects may inform how patients are monitored for toxicity and identify those groups, such as older people, that may need closer monitoring. For clinical trials in diseases commonly treated with glucocorticoids, standardised measurement of glucocorticoid-related adverse effects would facilitate future evidence synthesis and meta-analysis.

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“…After high-dose corticosteroid treatment, 12.6% of 127 Korean SLE patients developed diabetes mellitus [64]. Elevated fasting glucose was present in 20.2% of patients in a large multiethnic cohort of 1,494 patients with SLE [65].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Limitations of Standard Immunosuppressive Treatment in ANCA-Associated Vasculitis and Lupus Nephritis

Tesař

Hrušková²

2014

Nephron Clin Pract

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Introduction of the standard immunosuppressive treatment has dramatically changed the outcome of patients with both ANCA-associated vasculitis and lupus nephritis, transforming them from incurable diseases with very high short-term mortality to chronic debilitating diseases with much lower short-term, but still relatively high long-term, morbidity/mortality. Long-term morbidity with damage accumulating partly due to the adverse events of the available treatment (namely gonadal toxicity, malignancy, bone disease, cataracts, diabetes, and thromboembolic and cardiovascular disease) has become a major concern. Although cyclophosphamide-based regimens have been partly replaced by newer agents in both ANCA-associated vasculitis and lupus nephritis (namely rituximab or mycophenolate, respectively) their short-term and medium-term adverse events may not be significantly less frequent and we can only hope that new treatments will translate into better long-term outcomes including better long-term safety.

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Glucocorticoid-induced diabetes mellitus in patients with systemic lupus erythematosus treated with high-dose glucocorticoid therapy

Cited by 62 publications

References 41 publications

Hyperglycemia Induced by Glucocorticoids in Nondiabetic Patients: A Meta-Analysis

Hyperglycemia Induced by Glucocorticoids in Nondiabetic Patients: A Meta-Analysis

The Prediction and Monitoring of Toxicity Associated with Long-Term Systemic Glucocorticoid Therapy

Limitations of Standard Immunosuppressive Treatment in ANCA-Associated Vasculitis and Lupus Nephritis

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