Next Article in Journal
Clinical and Sociodemographic Factors Related to Amyotrophic Lateral Sclerosis in Spain: A Pilot Study
Previous Article in Journal
Amplitude of Lower Limb Muscle Activation in Different Phases of the Illinois Test in Parkinson’s Disease Patients: A Pilot Study
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Is It Time for a New Algorithm for the Pharmacotherapy of Steroid-Induced Diabetes?

by
Aleksandra Ostrowska-Czyżewska
,
Wojciech Zgliczyński
,
Lucyna Bednarek-Papierska
and
Beata Mrozikiewicz-Rakowska
*
Department of Endocrinology, Centre of Postgraduate Medical Education, Marymoncka St. 99/103, 01-813 Warsaw, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(19), 5801; https://doi.org/10.3390/jcm13195801 (registering DOI)
Submission received: 27 August 2024 / Revised: 16 September 2024 / Accepted: 18 September 2024 / Published: 28 September 2024
(This article belongs to the Section Endocrinology & Metabolism)

Abstract

Glucocorticoids (GS) are widely used in multiple medical indications due to their anti-inflammatory, immunosuppressive, and antiproliferative effects. Despite their effectiveness in treating respiratory, skin, joint, renal, and neoplastic diseases, they dysregulate glucose metabolism, leading to steroid-induced diabetes (SID) or a significant increase of glycemia in people with previously diagnosed diabetes. The risk of adverse event development depends on the prior therapy, the duration of the treatment, the form of the drug, and individual factors, i.e., BMI, genetics, and age. Unfortunately, SID and steroid-induced hyperglycemia (SIH) are often overlooked, because the fasting blood glucose level, which is the most commonly used diagnostic test, is insufficient for excluding both conditions. The appropriate control of post-steroid hyperglycemia remains a major challenge in everyday clinical practice. Recently, the most frequently used antidiabetic strategies have been insulin therapy with isophane insulin or multiple injections in the basal–bolus regimen. Alternatively, in patients with lower glycemia, sulphonylureas or glinides were used. Taking into account the pathogenesis of post-steroid-induced hyperglycemia, the initiation of therapy with glucagon-like peptide 1 (GLP-1) analogs and dipeptidyl peptidase 4 (DPP-4) inhibitors should be considered. In this article, we present a universal practical diagnostic algorithm of SID/SIH in patients requiring steroids, in both acute and chronic conditions, and we present a new pharmacotherapy algorithm taking into account the use of all currently available antidiabetic drugs.

Share and Cite

MDPI and ACS Style

Ostrowska-Czyżewska, A.; Zgliczyński, W.; Bednarek-Papierska, L.; Mrozikiewicz-Rakowska, B. Is It Time for a New Algorithm for the Pharmacotherapy of Steroid-Induced Diabetes? J. Clin. Med. 2024, 13, 5801. https://doi.org/10.3390/jcm13195801

AMA Style

Ostrowska-Czyżewska A, Zgliczyński W, Bednarek-Papierska L, Mrozikiewicz-Rakowska B. Is It Time for a New Algorithm for the Pharmacotherapy of Steroid-Induced Diabetes? Journal of Clinical Medicine. 2024; 13(19):5801. https://doi.org/10.3390/jcm13195801

Chicago/Turabian Style

Ostrowska-Czyżewska, Aleksandra, Wojciech Zgliczyński, Lucyna Bednarek-Papierska, and Beata Mrozikiewicz-Rakowska. 2024. "Is It Time for a New Algorithm for the Pharmacotherapy of Steroid-Induced Diabetes?" Journal of Clinical Medicine 13, no. 19: 5801. https://doi.org/10.3390/jcm13195801

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Article metric data becomes available approximately 24 hours after publication online.
Back to TopTop