Glucocorticoid-induced diabetes mellitus: prevalence and risk factors in primary renal diseases.
OBJECTIVE
In patients with primary renal diseases the current knowledge of hyperglycemia associated with corticosteroid therapy is limited. We therefore examined the prevalence and risk factors of glucocorticoid-induced diabetes mellitus (DM) in primary renal diseases.


METHODS
Patients were recruited with primary renal diseases who were started on corticosteroids between April 2002 and June 2005. In patients with DM, an impaired fasting glucose level and/or positive urinary glucose analyses before corticosteroids therapy were excluded.


RESULTS
During corticosteroid therapy (initial dose: prednisolone 0.75 +/- 0.10 mg/kg/day), DM was newly diagnosed in 17 (40.5%) of 42 patients. All of the 17 patients were diagnosed as having DM by postprandial hyperglycemia at 2 h after lunch, although they had normal fasting blood glucose levels. Age (OR 1.40, 95% CI 1.06-1.84) and body mass index (OR 1.87, 95% CI 1.03-3.38) were determined as independent risk factors for glucocorticoid-induced DM.


CONCLUSIONS
Over 40% of patients with primary renal disease developed DM during treatment with corticosteroids. A high age and high body mass index are the independent risk factors for glucocorticoid-induced DM. 24-hour urinary glucose analyses and postprandial plasma glucose are useful for detecting glucocorticoid-induced DM.
Uzu
T
T
Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan. takuzu@belle.shiga-med.ac.jp
Harada
T
T
Sakaguchi
M
M
Kanasaki
M
M
Isshiki
K
K
Araki
S
S
Sugiomoto
T
T
Koya
D
D
Haneda
M
M
Kashiwagi
A
A
Yamauchi
A
A
D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002940:Circadian Rhythm; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006029:Glycosuria / Q000503:physiopathology; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D007674:Kidney Diseases / Q000188:drug therapy*; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects; D008875:Middle Aged; D019518:Postprandial Period; D011239:Prednisolone / Q000009:adverse effects; D015995:Prevalence; D012307:Risk Factors
D001786:Blood Glucose; D005938:Glucocorticoids; D011239:Prednisolone; D008775:Methylprednisolone