Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy.
OBJECTIVE
Little data exist on the impact of chronic low dose corticosteroid therapy during pregnancy on gestational diabetes mellitus (GDM).


METHODS
We compared 25 pregnant women receiving long-term (>4 weeks) corticosteroid for newly diagnosed idiopathic thrombocytopenic purpura (ITP) (study group) and 108 normal pregnant women (control group) in this case-control study. Main outcome measures were 1-h, 50-g and 3-h, 100-g glucose tolerance tests (GTTs). Women in both groups were also screened with 75-g GTT 6 weeks after delivery.


RESULTS
The mean duration of corticosteroid therapy was 9.8+/-4.9 (range 6-25) weeks. Compared with controls, study group patients had a greater prevalence of diagnosed GDM (24.0 vs. 2.8%, P=0.01). Of these patients, 83.3% were diagnosed with GDM at 16 weeks gestation. An impaired 75-g GTT was also more frequent in the study group (P=0.01).


CONCLUSIONS
Our findings suggest that long-term corticosteroid therapy may be associated with the development of diabetes in pregnant women and early GTT should be performed in pregnant women on corticosteroid therapy.
Yildirim
Yusuf
Y
Aegean Obstetrics and Gynecology Training and Research Hospital, Department of Obstetrics and Gynecology, Yenisehir, Izmir, Turkey. dr.yusufyildirim@yahoo.tr
Tinar
Sivekar
S
Oner
Recai Soner
RS
Kaya
Baris
B
Toz
Emrah
E
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000209:etiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy; D011256:Pregnancy Outcome; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000188:drug therapy; D013997:Time Factors
D000305:Adrenal Cortex Hormones