title: Glucocorticoid-induced hyperglycemia.
abstract: OBJECTIVE
  To review the current literature on glucocorticoid-induced hyperglycemia and provide a strategy for its treatment.
  
  
  METHODS
  We undertook an electronic (MEDLINE) and a library review of the existing pertinent literature published from 1950 to March 2009.
  
  
  RESULTS
  Glucocorticoid-induced hyperglycemia is common in patients with and without diabetes. The odds ratio for new-onset diabetes mellitus in patients treated with glucocorticoids ranges from approximately 1.5 to 2.5. Total glucocorticoid dose and duration of therapy are strong predictors of diabetes induction. Other risk factors include age and body mass index. Failure to treat glucocorticoid-induced hyperglycemia is related to the presumed short duration of administration of glucocorticoid treatment and the emphasis on fasting plasma glucose only. Understanding the pharmacodynamics of glucocorticoids can lead to increased recognition and improved treatment of the condition. Recent demonstrations that even shortterm elevations in blood glucose level may be associated with adverse sequelae argue for greater attention to the condition.
  
  
  CONCLUSIONS
  Glucocorticoid-induced hyperglycemia is an important clinical finding that, if recognized, can be effectively treated. We propose a relatively simple schema for the proactive management of corticosteroid-induced hyperglycemia that has been effective and easily adaptable to both the inpatient and the outpatient setting.
authors.affiliation: Division of Endocrinology and Metabolism, Virginia Commonwealth University, Richmond, Virginia 23298, USA. jclore@mcvh-vcu.edu
authors.forename: John N
authors.initials: JN
authors.lastname: Clore
authors.forename: Linda
authors.initials: L
authors.lastname: Thurby-Hay
mesh_terms: D005938:Glucocorticoids / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000494:pharmacology; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D005938:Glucocorticoids