An open comparison of the diabetogenic effect of deflazacort and prednisone at a dosage ratio of 1.5 mg:1 mg.
OBJECTIVE
To compare the diabetogenic effects of deflazacort (D) versus prednisone (PN) using a dosage ratio of 1.5 mg deflazacort:1 mg prednisone.


METHODS
Thirty-three patients suffering from various active connective tissue or chronic inflammatory diseases were randomized to be treated with D or PN, assuming a therapeutic equipotency ratio of 1.5 mg D:1 mg PN. Neither dosage nor glucocorticoid employed were modified during the study. Patients had not received steroid treatment during the month prior to their inclusion date. Fasting glucose, glycosylated haemoglobin and fructosamine were determined before and after 1 month of treatment. Non-diabetic patients were also submitted to an oral glucose tolerance test (OGTT) at entry and after 1 month. Results were compared by univariate, and multivariate tests to correct the effects of age, body mass index and diagnosis.


RESULTS
After 1 month of treatment there were no differences between D and PN in fasting glucose, glycosylated haemoglobin, or fructosamine. OGTT performed after treatment showed similar glucose values for both treatment groups. Patients treated with D had insulin levels at min 60 of the post-treatment OGTT which were higher than those treated with PN [114.1 (62.8) mcUI x ml(-1) versus 73.5 (32.7) mcUI x ml(-1), P = 0.049], but the difference lost its statistical significance in the multivariate analysis.


CONCLUSIONS
D and PN have similar effects on glucose tolerance when an equipotency ratio of 1.5 mg D:1 mg PN is employed. Previous studies employing a ratio of 1.2:1 mg may have underestimated the adverse effects of D on glucose metabolism.
Sáez Barcelona
J A
JA
Department of Internal Medicine, Hospital General de Albacete, Spain. jasbar@datalogic.es
Carmona Martín
M
M
Navarro López
V
V
Blanch Sancho
J J
JJ
Puras Tellaeche
A
A
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001786:Blood Glucose / Q000187:drug effects*; D004334:Drug Administration Schedule; D005260:Female; D019270:Fructosamine / Q000097:blood; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology*; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011241:Prednisone / Q000008:administration & dosage / Q000494:pharmacology*; D011282:Pregnenediones / Q000008:administration & dosage / Q000494:pharmacology*; D011446:Prospective Studies
D000893:Anti-Inflammatory Agents; D001786:Blood Glucose; D019270:Fructosamine; D005938:Glucocorticoids; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents; D011241:Prednisone; D011282:Pregnenediones; C021988:deflazacort