A Prospective Study of Steroid Induced Hyperglycemia

To study the incidence of hyperglycemia in patients treated with steroid therapy and to study the type of hyperglycemia, if any, due to steroid therapy.

This was a prospective randomized study done in 40 patients admitted in Bharati Hospital, Pune, between November 2010 and March 2011. All patients admitted above the age of 18 years requiring 40 mgs of prednisolone or equivalent steroid for medical ailment were included in the study. Blood sugar levels of the patients, both fasting and post prandial, were measured at two stages, before and after three days of initiation of steroid therapy, at the interval of 3 days. ADA criteria was used to diagnose hyperglycemia and included both patients with impaired as well as diabetic range hyperglycemia.

In our study, 62.5% of cases developed hyperglycemia after steroid therapy. Out of these, 25% had steroid induced diabetes while 37.5% had impaired blood sugar levels. In the remaining 37.5% of cases, blood sugar levels where under normal range after 3 days of steroid therapy. By applying student t test it was found that compared to fasting (t = 5.91) post prandial blood sugar levels (t = 10.14) were highly significantly increased after the steroid therapy.

Glucocorticoids play a pivotal role in treatment of various medical diseases. However, these life saving drugs are not free from side effects; the most important being hyperglycemia. Clinicians should be aware that steroid induced hyperglycemia is more of postprandial type then fasting. So, it is mandatory to do postprandial glucose levels in patients receiving steroids.