title: Steroid-induced impairment of glucose tolerance: Prevalence among pediatric patients on long-term steroid use in Nigeria.
abstract: BACKGROUND
  Glucocorticoid (referred to from here on as simply steroid) is used for effective treatment of various inflammatory disorders since its discovery in 1940s. However, these useful drugs cause important side effects, such as impairment of glucose tolerance. We sought to determine the prevalence of steroid-induced impairment of glucose tolerance in pediatric patients on long-term steroid use.
  
  
  METHODS
  A cross-sectional, descriptive and hospital-based study. Consenting subjects who met the inclusion criteria were screened with random glucometer measurements repeated twice. An average of both readings obtained from the initial measurement of their random blood glucose (RBG) and a repeat during the next clinic visit was taken as the RBG.
  
  
  RESULTS
  Hundred patients were studied, 66 males/34 females. Subjects with nephrotic syndrome were 61 while 39 had asthma. Mean age of 10.13 years (range: 0.5-18 years); mean body mass index (BMI): 18.2 kg/m2(range: 6.6 to 26.30 kg/m2). The subjects with nephrotic syndrome were on oral prednisolone while the asthmatics were on inhaled fluticasone, budesonide and oral methylprednisolone. Mean (range) duration of steroid use was 9.74 (0.5-72) months. Mean (range) RBG was 3.49 (3.3-7.5) mmol/L. None of the subjects showed abnormal RBG. However, the RBG was further categorized into low, moderate and high normal RBG. A positive correlation between longer duration of steroid use as well as high doses of both oral and inhaled steroids, and high normal RBG existed (P = .015). No statistically significant relationship existed between body mass index (BMI) percentile and RBG (P = .437).
  
  
  CONCLUSIONS
  Low to moderate doses of oral and inhaled steroids should be used when indicated as they are associated with lesser risk of impairment of glucose tolerance in the pediatric population.
authors.affiliation: Department of Paediatrics, University of Nigeria, Nsukka, Enugu, Nigeria.
authors.forename: U N
authors.identifier: http://orcid.org/0000-0002-5293-0870
authors.initials: UN
authors.lastname: Chikani
authors.affiliation: Department of Paediatrics, Federal Teaching Hospital, Abakaliki, Nigeria.
authors.forename: M U
authors.initials: MU
authors.lastname: Ibekwe
authors.affiliation: Department of Paediatrics, University of Nigeria, Nsukka, Enugu, Nigeria.
authors.forename: T
authors.initials: T
authors.lastname: Oguonu
authors.affiliation: Department of Paediatrics, University of Nairobi, Nairobi, Kenya.
authors.forename: L
authors.initials: L
authors.lastname: Mungai
authors.affiliation: Department of Paediatrics, University of Nigeria, Nsukka, Enugu, Nigeria.
authors.forename: A I
authors.initials: AI
authors.lastname: Bisi-Onyemaechi
authors.affiliation: Department of Paediatrics, Usman Danfodio University, Sokoto, Nigeria.
authors.forename: O M
authors.initials: OM
authors.lastname: Ugege
authors.affiliation: Department of Paediatrics, Abia State University, Okigwe, Nigeria.
authors.forename: I F
authors.initials: IF
authors.lastname: Ogbonna
authors.affiliation: DECCP, Clinique Pédiatrique/CH de Luxembourg, Luxembourg.
authors.forename: Carine
authors.initials: C
authors.lastname: de Beaufort
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D044882:Glucose Metabolism Disorders / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids
keywords: impairment of glucose tolerance; long term; pediatric; steroids