Glucocorticoid‐induced diabetes among people without diabetes: a literature review. (6th April 2018) - Alabbood, Majid
Abstract: The effect of glucocorticoid on glycaemic control in people with diabetes has been studied extensively in the literature. However, data regarding its effect on glucose homeostasis in those without diabetes are sparse. This review aims to investigate the incidence of glucocorticoid‐induced diabetes among people without diabetes subjected to high‐dose glucocorticoid, to determine its associated risk factors and to examine the effect of high‐dose glucocorticoid on glucose homeostasis. Four databases (Ovid Medline, Scopus, Embase, and PubMed) were searched until August 2017 using the following MeSH terms: 'glucocorticoid*', 'dexamethasone', 'diabetes mellitus' and 'incidence'. Only studies that included the use of high‐dose glucocorticoid (equivalent to 4 mg dexamethasone per day) for at least seven days in their methodology were included. Nine out of 302 identified studies were included in this review. The incidence of glucocorticoid‐induced diabetes ranged from 1–50%. Pre‐diabetes, age, cumulative dose of glucocorticoid and family history of diabetes were predictors of glucocorticoid‐induced diabetes. The use of high‐dose glucocorticoid aggravated insulin resistance. Most of the studies were retrospective, and used low‐dose glucocorticoid with a short follow‐up period. The incidence of glucocorticoid‐induced diabetes reported varies widely depending on the type, dose and duration of glucocorticoid, the underlying condition and the presence of established risk factors for diabetes. Further prospective studies testing the effect of glucocorticoid in those without pre‐existing risk factors are required to accurately estimate the incidence of glucocorticoid‐induced diabetes. Copyright © 2018 John Wiley & Sons.