Dose-sensitive steroid-induced hyperglycaemia.
Steroids cause significant but under-appreciated and poorly managed glucose intolerance. In this case we describe a patient with steroid-induced hyperglycaemia who obtained a large positive impact on glycaemic control from a small reduction in her steroid dose, sufficient to alleviate the need for insulin. Developments in the treatment of steroid-induced hyperglycaemia may mean that a more active approach needs to be considered when treating steroid-related diabetes in patients whose management is palliative. We advise checking for steroid-induced hyperglycaemia by testing capillary blood glucose values 2 hours after the lunchtime meal and recommend a single morning dose of long-acting insulin to treat the condition.
Gannon
Craig
C
Princess Alice Hospice-Palliative Medicine, Esher, UK.
Dando
Nicholas
N
D001650:Bile Duct Neoplasms / Q000188:drug therapy*; D001786:Blood Glucose / Q000378:metabolism; D018281:Cholangiocarcinoma / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008875:Middle Aged; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin