Diabetes

Description: In most cases, diabetes does not create symptoms and is diagnosed upon a blood screening. When there are symptoms, it may be an unusual combination of thirst and/or frequent urination.

Frequency: Certain studies have estimated that about 5% of patients treated with cortisone have developed diabetes in the year following treatment. This is 1.5 to 2 times higher than the figure observed in a similar group of individuals not given corticosteroids.

Subjects at risk: Older patients, those receiving the highest doses of cortisone and those treated for several months are most at risk. It is also very likely that patients reporting weight gain caused by cortisone will have a higher risk of diabetes. Finally, in people that already have diabetes, it is very likely that corticosteroids will affect their blood glucose levels.

Long versus short-term treatment: Prolonged treatment with corticosteroids exposes to more risk of developing diabetes. To the contrary, corticosteroids may trigger diabetic symptoms after only a few days of treatment in those with pre-existing diabetes.

Prevention/treatment: It is likely that limited weight gain is a good way to prevent diabetes while taking cortisone. If you have diabetes after taking cortisone, a healthy diet and medication will be prescribed.

Screening: A blood test may be required.

Reversiblity: the level of blood glucose usually normalised or improved and balanced when corticosteroids are reduced or stopped.

GOOD TO KNOW
  • If you have pre-existing diabetes and you will undergo cortisone treatment, regular monitoring of your blood glucose level is very important. Notify your doctor of all pre-existing medical conditions before beginning treatment.

 

Useful references
  • Blackburn D et al. Quantification of the Risk of Corticosteroid-induced Diabetes Mellitus among the Elderly. J Gen Intern Med. 2002
  • Gurwitz JH et al. Glucocorticoids and the risk for initiation of hypoglycemic therapy. Arch Intern Med. 1994
  • Conn HO et al. Corticosteroids and peptic ulcer: meta-analysis of adverse events during steroid therapy. J Intern Med. 1994
  • Gulliford MC et al. Risk of diabetes associated with prescribed glucocorticoids in a large population. Diabetes Care. 2006
  • Feldman-Billard S et al. Short-term tolerance of pulse methylprednisolone therapy in patients with diabetes mellitus. Ophthalmology. 2005

lastest update : May 08 2015