The effect of chronic steroid therapy on glucose tolerance in pregnancy.
We analyzed the records of 26 pregnant patients receiving chronic steroids to assess the combined effect of pregnancy and glucocorticoid administration on glucose tolerance. Five patients (19.2%) developed diabetes mellitus, four of whom required insulin. In a pregnant control group of 1325 patients, 53 patients (4.0%) developed diabetes mellitus, five of whom required insulin. Glucose intolerance was significantly higher in the steroid-treated group (p = 0.003). Comparison with a nonpregnant steroid-treated control group (47 patients, 15% of whom developed diabetes mellitus) showed no significant different (p = 0.23) between the two. All pregnant steroid-treated patients developing diabetes mellitus began steroid therapy after conception, whereas none of the patients receiving steroid therapy before conception developed glucose intolerance (p = 0.012). There does not appear to be an additive effect of steroid treatment and pregnancy on glucose intolerance; however, all patients receiving steroids should undergo periodic glucose screening.
Department of Obstetrics and Gynecology, George Washington University Medical Center, Washington, DC 20037.
H J
HJ
Landy
N B
NB
Isada
J
J
McGinnis
R
R
Ratner
J H
JH
Grossman
D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D005951:Glucose Tolerance Test; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000378:metabolism*; D011254:Pregnancy in Diabetics / Q000378:metabolism
D005938:Glucocorticoids