title: Hyperglycemia in hospitalized patients receiving corticosteroid premedication before the administration of radiologic contrast medium.
abstract: OBJECTIVE
  To assess the effect of short-term corticosteroid premedication on serum glucose in hospitalized patients.
  
  
  METHODS
  Serum glucose in adult inpatients receiving corticosteroid premedication before a radiology study was compared to serum glucose in nonpremedicated controls between May 1, 2008, and September 12, 2009. Patients were categorized by type of nonionic contrast medium (intravenous [IV] or none) and route of corticosteroid premedication (oral, IV, none). Diabetes mellitus (types I and II) was evaluated as an independent risk factor. Patients without glucose estimations before and after premedication were excluded. Results were analyzed with analysis of variance and a stepwise linear regression analysis.
  
  
  RESULTS
  There were 390 corticosteroid premedication episodes in 390 patients; 873 examinations in 844 patients served as controls. Cohorts receiving corticosteroid premedication experienced a brief (24-48 hour) increase in mean maximum postbaseline serum glucose (IV, +81 mg/dL; oral, +70 mg/dL) that was greater than the increase in nonpremedicated controls (+46 mg/dL). Type I (+144 mg/dL) and type II (+108 mg/dL) diabetics had a greater elevation than nondiabetics (+34 mg/dL). Both corticosteroid premedication (IV, P = .02; oral, P = .01) and diabetes mellitus (type I, P = .0002; type II, P < .0001) were significant independent risk factors of hyperglycemia. The use of nonionic intravascular contrast medium was not (P = .7). There was no significant difference between IV and oral premedication (P = .6), or type I and type II diabetes mellitus (P = .8).
  
  
  CONCLUSIONS
  Diabetes mellitus (type I and type II) and corticosteroid premedication (oral and IV) are significant independent risk factors for the development of brief hyperglycemia near the time of inpatient radiology studies.
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA. matdaven@med.umich.edu
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Davenport
authors.forename: Richard H
authors.initials: RH
authors.lastname: Cohan
authors.forename: Shokoufeh
authors.initials: S
authors.lastname: Khalatbari
authors.forename: James
authors.initials: J
authors.lastname: Myles
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Caoili
authors.forename: James H
authors.initials: JH
authors.lastname: Ellis
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003287:Contrast Media / Q000008:administration & dosage*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D011292:Premedication / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D003287:Contrast Media