Systemic glucocorticoids are commonly used for the treatment of lung diseases and other illnesses. One of the more common side effect of glucocorticoids that requires proper treatment is elevated blood sugar. The purpose of this study was to analyze and evaluate the regulation of blood sugar levels in patients who received systemic treatment with glucocorticoids during their hospital treatment at the University Clinic Golnik. During the study, we developed a treatment protocol for glucocorticoid-induced hyperglycemia.
The four-month retrospective study (May-August 2019) included all patients who received systemic glucocorticoids for at least 2 days during hospitalisation and had at least 2 measured blood sugar values of ⡥ 7.0 mmol/L in the morning on an empty stomach or ⡥ 10.0 mmol/L anytime during the day.
Out of 280 patients who were receiving systemic glucocorticoids during their hospitalisation, 55 patients (20 %) with established hyperglycemia were included in the study. 30 patients developed exacerbation of pre-existing diabetes during treatment, 3 patients developed newly diagnosed diabetes, and 22 patients developed steroid diabetes. A total of 1,535 blood sugar measurements were performed, of which 57.3 % presented elevated values. The mean value of measurements in the morning on an empty stomach was 7.94 ± 3.31 mmol/L, whereas measurements during the day showed a mean value of 11.28 ± 4.20 mmol/L. During their hospitalisation, 45 patients (82 %) presented more than 5 elevated measurements of blood sugar or > 20 % of a patient’s total measurements. A total of 9 patients (16,4 %) had regulated blood sugar levels according to all three criteria. Some form of antidiabetic therapy adjustment (initiation, replacement, discontinuation, change of dosage of antidiabetics,) was undertaken with 35 patients (63.6 %). Only 18 patients had their hyperglycemia treated in full accordance with the treatment protocol.
Treatment of glucocorticoid-induced hyperglycemia was inadequate in more than 80 % of patients. The developed treatment protocol can help to better treat such patients.
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