Incidence and control of steroid-induced hyperglycaemia in hospitalised patients at a tertiary care centre for lung diseases

Abstract

Background The aim of this study was to determine the incidence of steroid-induced hyperglycaemia (SIH) in patients hospitalised at the tertiary centre for lung diseases, to assess glycaemic control during hospitalisation, and to determine the factors associated with the control of SIH. Methods A 4-month retrospective study was conducted. All patients who received systemic glucocorticoids for ≥ 2 days during hospitalisation, with ≥ 2 elevated blood glucose (BG) readings, were included in the analysis. SIH control was determined by mean BG levels, the number and proportion of elevated and pronouncedly elevated BG readings, and the number of hypoglycaemic events. Results 60 of 283 patients (21.2%) developed SIH, of which 55 patients were included in further analysis. Mean fasting and daytime BG levels were 7.8 ± 2.9 mmol/l and 10.9 ± 2.2 mmol/l, respectively. 41/55 patients (74.5%) had elevated average BG levels. 45/55 patients (81.8%) had > 5 readings or > 20% of all readings exceeding hyperglycaemia threshold, and 33/55 patients (60.0%) had pronouncedly elevated BG levels on more than one occasion. 6/55 patients (10.9%) experienced more than one hypoglycaemic event or a severe hypoglycaemia. Only 9/55 patients (16.4%) achieved adequate SIH control according to all defined criteria. Pre-existing diabetes and longer duration of hospital treatment with low glucocorticoid dose were significantly associated with poorer glycaemic control ( p < 0.001 and p = 0.003, respectively). Conclusions Appropriate SIH management was demonstrated to be challenging. According to the defined criteria, adequate glycaemic control during hospitalisation was not achieved in the large majority of patients with SIH. Supplementary Information The online version contains supplementary material available at 10.1007/s43440-021-00234-2.

Features of the course of COVID-19 in pregnant women

“…Среди наших пациенток сахарного диабета выявлено не было; но в 24,8 % случаев зарегистрирована гипергликемия на фоне терапии ГК, при отмене препаратов уровень глюкозы нормализовался. По данным различных источников, гипергликемия при COVID-19 встречается в 20-70 % случаев [22,23].…”

“…Имеющиеся на сегодняшний день данные не позволяют достоверно оценить влияние COVID-19 на материнскую смертность в популяции в целом. К настоящему времени показатели материнской смертности за 2020 г. представили около 20 % стран, в которых нерепрезентативно высока доля обеспеченных и / или сравнительно небольших групп населения, что ограничивает возможность экстраполяции оценок на генеральную совокупность [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Combination therapy with predicted body weight-based dexamethasone, remdesivir, and baricitinib in patients with COVID-19 pneumonia: A single-center retrospective cohort study during 5th wave in Japan

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