Hyperglycemia induced by glucocorticoids in nondiabetic patients: a meta-analysis.
OBJECTIVE
Glucocorticoids are associated with a number of side effects including the development of new-onset hyperglycemia or diabetes. The diagnosis and treatment of glucocorticoid-induced hyperglycemia are surprisingly undervalued by many health-care professionals, probably due to the lack of quality studies that assess specific reasons for and prevention of hyperglycemia. The aim of this meta-analysis was to evaluate the long-term incidence of glucocorticoid-induced hyperglycemia and diabetes in nondiabetic patients who received glucocorticoid treatment.


METHODS
We searched Medline, Embase, and the Cochrane Library (Central) until January 2014 for studies in which subjects received systematic glucocorticoid treatment and which evaluated whether subjects developed hyperglycemia or were diagnosed with diabetes following treatment. The primary outcome for this analysis was the incidence of hyperglycemia and the secondary outcome was the frequency of diabetes.


RESULTS
We identified 13 studies that met our inclusion criteria; 12 of the studies were retrospective or observational in design. We found that the rate at which patients developed glucocorticoid-induced hyperglycemia or diabetes was 32.3% (p = 0.003) and 18.6% (p = 0.002), respectively.


CONCLUSIONS
Our meta-analysis indicated that glucocorticoid-induced hyperglycemia occurs fairly frequently and points to the need for the design of prospective, randomized, controlled studies to further investigate and better understand this medical problem.
Department of Endocrinology and Metabolism, Northern Branch of Huashan Hospital, Shanghai, China.
Xiao-xia
XX
Liu
Xiao-ming
XM
Zhu
Qing
Q
Miao
Hong-ying
HY
Ye
Zhao-yun
ZY
Zhang
Yi-Ming
YM
Li
D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000453:epidemiology*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000453:epidemiology*; D015994:Incidence; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic
D005938:Glucocorticoids; D011239:Prednisolone