Systemic Steroids and Their Role in Diabetes Onset

Glucocorticoids (also known as steroids) are anti-inflammatory drugs used to treat several inflammatory and autoimmune disorders, including asthma, rheumatoid arthritis, cancer, and other medical issues. Glucocorticoids have several negative consequences, including raising blood sugar levels and causing diabetes, even though they can be quite successful at reducing inflammation. This is more likely to happen when using glucocorticoids as pills or injections instead of inhalers, lotions, or drops.

In a recent study, experts at the Diabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK, examined the frequency at which patients receiving glucocorticoid treatment can acquire new-onset diabetes.

The study revealed that patients on systemic glucocorticoids had a 2.6-fold increased risk of developing diabetes compared to those not on the medication(1^✔ ✔Trusted Source
Steroid-induced diabetes

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Systemic Glucocorticoids and Diabetes Risk

Study leader Dr Rajna Golubic, said: “Existing information on how much more common new diabetes is in patients treated with glucocorticoids is based on small studies including patients with one or a few conditions. We wanted to expand the data to get a more accurate idea of how likely it is that people could develop diabetes while being treated with these drugs.”

Dr Golubic and colleagues compared the rate of new-onset diabetes in hospital patients who received systemic glucocorticoids (tablets, injections, or infusions) to patients not treated with these drugs.

The study involved 451,606 adults (median age 52 years, 55% female, 69% White) who were admitted to the Oxford University Hospitals NHS Foundation Trust between 1 January 2013 and 1 October 2023. All were free from diabetes at the start of the study and none were taking systemic glucocorticoids.

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Surprising Link Between Steroid Treatment and Diabetes

• 17,258 (3.8%) of the patients were treated with systemic glucocorticoids (some names include prednisolone, hydrocortisone, and dexamethasone) while in hospital, most commonly for autoimmune and inflammatory diseases and infections.
• 316 of these 17,258 patients (1.8%) developed diabetes while in hospital.
• This compares with 3,430 of the 434,348 patients (0.8%) who didn’t receive systemic glucocorticoids. Patients were typically admitted for less than a week.

Further analysis showed that when age and gender were factored in, patients receiving systemic glucocorticoids were more than twice as likely (2.6 times) to develop diabetes as those not receiving the treatment.

Dr Golubic says: “These latest results give clinical staff a better estimate of how likely new diabetes is to occur and could prompt doctors to plan clinical care more effectively to detect and manage new diabetes.

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“While we studied hospital patients, glucocorticoid tablets can be prescribed by GPs for conditions such as asthma and rheumatoid arthritis and it is important that they, too, are aware of the link.”

She added: “This study also shows how routinely collected clinical data can be used to help people with diabetes.”

Reference:

1. Steroid-induced diabetes - (https:www.diabetes.org.uk/diabetes-the-basics/other-types-of-diabetes/steroid-induced-diabetes)

Source-Eurekalert