Glucocorticoid-Induced Diabetes Mellitus: Prevalence and Risk Factors in Primary Renal DiseasesUzu T.a · Harada T.b · Sakaguchi M.a · Kanasaki M.a · Isshiki K.a · Araki S.a · Sugiomoto T.a · Koya D.c · Haneda M.d · Kashiwagi A.a · Yamauchi A.b
aDepartment of Medicine, Shiga University of Medical Science, Otsu, Shiga, bDivision of Nephrology, Osaka Rosai Hospital, Sakai, Osaka, cDepartment of Medicine, Division of Endocrinology & Metabolism, Kanazawa Medical University, Kanazawa, Ishikawa, dSecond Department of Medicine, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
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Background/Aims: In patients with primary renal diseases the current knowledge of hyperglycemia associated with corticosteroid therapy is limited. We therefore examined the prevalence and risk factors of glucocorticoid-induced diabetes mellitus (DM) in primary renal diseases. Methods: Patients were recruited with primary renal diseases who were started on corticosteroids between April 2002 and June 2005. In patients with DM, an impaired fasting glucose level and/or positive urinary glucose analyses before corticosteroids therapy were excluded. Results: During corticosteroid therapy (initial dose: prednisolone 0.75 ± 0.10 mg/kg/day), DM was newly diagnosed in 17 (40.5%) of 42 patients. All of the 17 patients were diagnosed as having DM by postprandial hyperglycemia at 2 h after lunch, although they had normal fasting blood glucose levels. Age (OR 1.40, 95% CI 1.06–1.84) and body mass index (OR 1.87, 95% CI 1.03–3.38) were determined as independent risk factors for glucocorticoid-induced DM. Conclusion: Over 40% of patients with primary renal disease developed DM during treatment with corticosteroids. A high age and high body mass index are the independent risk factors for glucocorticoid-induced DM. 24-hour urinary glucose analyses and postprandial plasma glucose are useful for detecting glucocorticoid-induced DM.
© 2007 S. Karger AG, Basel
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