TY - JOUR
T1 - Risk factors for the development of glucocorticoid-induced diabetes mellitus
AU - Katsuyama, Takayuki
AU - Sada, Kenei
AU - Namba, Sayaka
AU - Watanabe, Haruki
AU - Katsuyama, Eri
AU - Yamanari, Toshio
AU - Wada, Jun
AU - Makino, Hirofumi
N1 - Funding Information:
J.W. is a consultant for Astellas and Boehringer Ingelheim and receives speaker honoraria from Novartis, Boehringer Ingelheim and Novo Nordisk. H.M. is a consultant for AbbVie, Astellas and Teijin, receives speaker honoraria from Astellas, Boehringer Ingelheim, Chugai, Daiichi Sankyo, Dainippon Sumitomo, Kyowa Hakko Kirin, MSD, Novartis, Pfizer, Takeda, and Tanabe Mitsubishi and receives grant support from Astellas , Boehringer Ingelheim , Daiichi Sankyo , Dainippon Sumitomo , Kyowa Hakko Kirin , Mochida , MSD , Novartis , Novo Nordisk , Pfizer , Takeda and Tanabe Mitsubishi .
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Aims: To evaluate the incidence of glucocorticoid-induced diabetes mellitus (GC-DM) by repeated measurements of the postprandial glucose and detect predictors for the development of GC-DM. Methods: Inpatients with rheumatic or renal disease who received glucocorticoid therapy were enrolled in this study. We compared the clinical and laboratory parameters of the GC-DM group with the non-GC-DM group and performed a multivariate analysis to identify risk factors. Results: During a four-week period, 84 of the 128 patients (65.6%) developed GC-DM. All patients were diagnosed based on the detection of postprandial hyperglycemia. The GC-DM group had an older age (65.2 vs. 50.4 years, p<0.0001), higher levels of fasting plasma glucose (93.3 vs. 89.0mg/dl, p=0.027) and HbA1c (5.78 vs. 5.50%, 39.7 vs. 36.6mmol/mol, p=0.001) and lower eGFR values (54.0 vs. 77.1ml/min/1.73m2, p=0.0003) than the non-GC-DM group. According to the multivariate analysis, an older age (more than or equal to 65 years), higher HbA1c level (more than or equal to 6.0%) and lower eGFR (<40ml/min/1.73m2) were identified as independent risk factors for GC-DM (OR 2.95, 95% CI 1.15-7.92, OR: 3.05, 95% CI 1.11-9.21, OR: 3.42, 95% CI: 1.22-10.8, respectively). The risk ratio for the development of GC-DM in the patients with at least one of these three risk factors was 2.28. The dose of glucocorticoids was not statistically related to the development of GC-DM. Conclusions: Patients with an older age, higher HbA1c level and lower eGFR require close monitoring for the development of GC-DM, regardless of the dose of glucocorticoids being administered.
AB - Aims: To evaluate the incidence of glucocorticoid-induced diabetes mellitus (GC-DM) by repeated measurements of the postprandial glucose and detect predictors for the development of GC-DM. Methods: Inpatients with rheumatic or renal disease who received glucocorticoid therapy were enrolled in this study. We compared the clinical and laboratory parameters of the GC-DM group with the non-GC-DM group and performed a multivariate analysis to identify risk factors. Results: During a four-week period, 84 of the 128 patients (65.6%) developed GC-DM. All patients were diagnosed based on the detection of postprandial hyperglycemia. The GC-DM group had an older age (65.2 vs. 50.4 years, p<0.0001), higher levels of fasting plasma glucose (93.3 vs. 89.0mg/dl, p=0.027) and HbA1c (5.78 vs. 5.50%, 39.7 vs. 36.6mmol/mol, p=0.001) and lower eGFR values (54.0 vs. 77.1ml/min/1.73m2, p=0.0003) than the non-GC-DM group. According to the multivariate analysis, an older age (more than or equal to 65 years), higher HbA1c level (more than or equal to 6.0%) and lower eGFR (<40ml/min/1.73m2) were identified as independent risk factors for GC-DM (OR 2.95, 95% CI 1.15-7.92, OR: 3.05, 95% CI 1.11-9.21, OR: 3.42, 95% CI: 1.22-10.8, respectively). The risk ratio for the development of GC-DM in the patients with at least one of these three risk factors was 2.28. The dose of glucocorticoids was not statistically related to the development of GC-DM. Conclusions: Patients with an older age, higher HbA1c level and lower eGFR require close monitoring for the development of GC-DM, regardless of the dose of glucocorticoids being administered.
KW - Glucocorticoid-induced diabetes mellitus
KW - Renal disease
KW - Rheumatic disease
KW - Risk factor
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U2 - 10.1016/j.diabres.2015.02.010
DO - 10.1016/j.diabres.2015.02.010
M3 - Article
C2 - 25765669
AN - SCOPUS:84927912961
SN - 0168-8227
VL - 108
SP - 273
EP - 279
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 2
ER -