title: The high incidence of steroid-induced hyperglycaemia in hospital.
abstract: OBJECTIVE
  The objective of this study was to systematically evaluate the incidence of steroid-induced hyperglycaemia in a tertiary referral hospital. We conducted a glucometric audit of a prospective protocol where glucose monitoring was routinely performed on patients treated with high-dose steroids.
  
  
  METHODS
  The protocol specified routine fingerprick glucose monitoring for patients commencing high-dose steroid therapy (prednisone 25mg/day, dexamethasone 4 mg/day, hydrocortisone 100mg/day, or more) for a minimum of 48 h. The medical records and charts of these patients were audited after a 6 month period.
  
  
  RESULTS
  There were 80 non-diabetic patients treated with high-dose steroids and 862 blood glucose (BG) readings were recorded. The mean BG was ≥8 mmol/L in 38 (48%) patients and ≥10 mmol/L in 11 (14%) subjects. Sixty-nine (86%) subjects had at least one BG ≥8 mmol/L, and 56 (70%) subjects had at least one BG ≥10 mmol/L. Among those with hyperglycaemia, it had developed within 48 h in 94% of subjects. When prednisone was administered as a once daily morning dose, glucose levels peaked in the afternoon, and would return to baseline by the next morning.
  
  
  CONCLUSIONS
  We conclude that steroid-induced hyperglycaemia is common in hospital. Patients should be monitored for hyperglycaemia upon commencement of high-dose steroid therapy and treatment commenced as indicated.
authors.affiliation: Department of Diabetes & Endocrinology, Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Ashley C
authors.initials: AC
authors.lastname: Fong
authors.forename: N Wah
authors.initials: NW
authors.lastname: Cheung
mesh_terms: D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose; D003907:Dexamethasone / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects*; D006943:Hyperglycemia / Q000139:chemically induced* / Q000453:epidemiology; D015994:Incidence; D011241:Prednisone / Q000009:adverse effects*; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D003907:Dexamethasone; D011241:Prednisone; D006854:Hydrocortisone