{ "schemaVersion": 2, "eyebrow": "Endocrinology", "title": "Steroid-Induced Hyperglycemia", "summary": "Adjust insulin to the glucocorticoid’s timing and glucose pattern, prioritize postprandial surveillance, treat persistent hyperglycemia with scheduled insulin, and reduce insulin promptly as steroid exposure falls to prevent hypoglycemia.", "seoDescription": "Practical insulin adjustment for steroid-induced hyperglycemia: glucose monitoring, emergency thresholds, steroid-pattern matching, and taper safety.", "clinicalQuestion": "How should clinicians monitor and adjust insulin for hyperglycemia caused or worsened by systemic glucocorticoids?", "specialty": "Endocrinology", "audience": "U.S. physicians and medical trainees", "tags": [ "steroid-induced hyperglycemia", "glucocorticoid-induced diabetes", "insulin adjustment", "NPH insulin", "hospital hyperglycemia" ], "keyTakeaways": [ "Initiate bedside point-of-care glucose testing in every patient receiving glucocorticoid therapy, whether or not diabetes was previously diagnosed. [12]", "Do not rely on fasting glucose alone after a single morning intermediate-acting glucocorticoid dose; postprandial hyperglycemia is typically more pronounced and fasting testing can miss clinically important dysglycemia. [18][22]", "Persistent hyperglycemia during glucocorticoid exposure warrants scheduled insulin therapy; match insulin timing and action profile to the steroid regimen. [11][1]", "For steroid-treated patients, reduce glucose-lowering treatment when the steroid dose is substantially reduced; failure to down-titrate is a frequent cause of hypoglycemia. [1]", "Send patients for emergency assessment when glucose exceeds 15 mmol/L (270 mg/dL) with ketones above 2 mmol/L, or when glucose is persistently above 20 mmol/L (360 mg/dL) or reads \"HI.\" [1]" ], "sections": [ { "id": "triage-and-baseline-assessment", "eyebrow": "First decision", "heading": "Identify emergencies and establish the steroid-linked glucose pattern", "intro": "Separate hyperglycemic crisis from routine insulin adjustment before changing outpatient or ward regimens.", "paragraphs": [ "Refer directly for emergency assessment when blood glucose is greater than 15 mmol/L (270 mg/dL) with ketones greater than 2 mmol/L, indicating high risk for diabetic ketoacidosis, or when glucose is persistently greater than 20 mmol/L (360 mg/dL) or registers as \"HI,\" suggesting hyperosmolar hyperglycemic state risk. [1]", "For nonemergent patients, document the glucocorticoid agent, dose, route, dosing frequency, and anticipated taper or stop date before selecting insulin. Glucocorticoids increase hepatic glucose production, impair peripheral glucose uptake, and increase insulin resistance; the clinical result is commonly disproportionate postprandial rather than fasting hyperglycemia. [13][22]", "Obtain bedside point-of-care glucose monitoring for any inpatient receiving glucocorticoids, including patients without known diabetes. A random glucose above 140 mg/dL identifies inpatient hyperglycemia requiring clinical attention, while repeated values of at least 11.1 mmol/L (200 mg/dL) during steroid exposure support steroid-induced hyperglycemia in a patient without prior diabetes. [12][2][1]" ], "bullets": [ "Record a baseline HbA1c when feasible: a newly elevated HbA1c of at least 6.5% plus steroid-associated hyperglycemia is categorized as steroid-induced diabetes in the cited consensus framework. [1]", "Interpret an elevated HbA1c as evidence of more sustained dysglycemia, but do not defer treatment while awaiting it when repeated point-of-care glucose values are elevated. [1][12]", "Treat acute illness, enteral or parenteral nutrition, and preexisting diabetes as concurrent contributors; glucocorticoids may exacerbate established diabetes, unmask previously undiagnosed diabetes, or cause new dysglycemia. [18]" ], "subsections": [], "table": { "caption": "Glucose thresholds that change immediate management in steroid-treated patients. [1][2]", "columns": [ "Finding", "Interpretation", "Immediate action" ], "rows": [ [ "Random glucose >140 mg/dL", "Inpatient hyperglycemia threshold for clinical evaluation. [2]", "Begin or intensify point-of-care monitoring and review steroid timing, nutrition, and current diabetes therapy. [2][12]" ], [ "Repeated glucose ≥200 mg/dL during steroid exposure", "Steroid-induced hyperglycemia criterion in a patient without prior diabetes. [1]", "Institute a scheduled glucose-lowering plan; persistent hyperglycemia on glucocorticoids warrants insulin therapy. [11]" ], [ "Glucose >270 mg/dL plus ketones >2 mmol/L", "High risk for diabetic ketoacidosis. [1]", "Refer for emergency hospital assessment and management. [1]" ], [ "Glucose persistently >360 mg/dL or meter reads \"HI\"", "Hyperosmolar hyperglycemic state risk. [1]", "Refer for emergency hospital assessment and management. [1]" ] ] } }, { "id": "monitoring-timed-to-steroid", "eyebrow": "Monitoring", "heading": "Measure glucose when the glucocorticoid is most likely to raise it", "intro": "The sampling schedule should detect the steroid effect rather than falsely reassure with a normal fasting value.", "paragraphs": [ "With most glucocorticoid regimens, preferentially assess postprandial glucose because glucocorticoid exposure produces greater postprandial than fasting hyperglycemia. A normal fasting result does not exclude clinically meaningful steroid-induced hyperglycemia, particularly after a single morning dose of an intermediate-acting agent. [22][18]", "For cyclic or intermittent high-dose steroid regimens, obtain glucose screening before each treatment cycle and again 4 to 6 hours after glucocorticoid intake. This approach detected steroid-associated hyperglycemia in hematologic patients and targets the expected early rise after dosing. [10]", "Reassess glucose values whenever the glucocorticoid dose, timing, formulation, or frequency changes. Insulin needs follow steroid exposure; a regimen that is adequate during high-dose therapy can cause hypoglycemia after a steroid reduction or discontinuation. [1]" ], "bullets": [ "Ask patients receiving outpatient glucose-lowering therapy to recognize and respond to hypoglycemia, especially during a steroid taper. [1]", "Provide explicit return precautions for severe hyperglycemia symptoms and emergency glucose or ketone thresholds rather than relying on routine follow-up. [1]", "Do not use fasting glucose as the sole screening test for a patient receiving single morning intermediate-acting glucocorticoids. [18]" ], "subsections": [], "table": { "caption": "Monitoring priorities by steroid-use context. [10][12][18][22]", "columns": [ "Clinical context", "Most informative monitoring approach", "What changes management" ], "rows": [ [ "Any hospitalized patient receiving glucocorticoids", "Initiate bedside point-of-care glucose testing irrespective of diabetes history. [12]", "Persistent hyperglycemia triggers scheduled insulin therapy. [11]" ], [ "Single morning intermediate-acting glucocorticoid", "Check postprandial values; fasting glucose may underestimate dysglycemia. [18][22]", "Postprandial elevation supports steroid-patterned insulin adjustment rather than reassurance from fasting values. [18]" ], [ "Intermittent high-dose steroid cycle", "Screen before each cycle and 4-6 hours after steroid administration. [10]", "Repeated elevations during cycles justify a reproducible cycle-specific treatment plan. [10]" ], [ "Steroid taper or discontinuation", "Review glucose trends and insulin exposure with each meaningful steroid reduction. [1]", "Reduce glucose-lowering treatment to limit hypoglycemia. [1]" ] ] } }, { "id": "insulin-selection-and-adjustment", "eyebrow": "Treatment", "heading": "Use scheduled insulin matched to steroid exposure", "intro": "Persistent steroid-related hyperglycemia is managed with insulin; select the basal strategy around steroid duration and dosing pattern.", "paragraphs": [ "Initiate insulin for persistent hyperglycemia while the patient is receiving glucocorticoid therapy. In moderate to severe steroid-induced hyperglycemia, insulin is the principal treatment approach; morning intermediate-acting isophane insulin or morning mixed insulin can be matched to the glycemic effect of steroid treatment. [11][1]", "For a morning intermediate-acting glucocorticoid regimen with predominantly later-day glucose elevation, consider morning NPH/isophane insulin because its action profile can be aligned to the anticipated steroid-related glucose rise. If the patient requires a basal-bolus regimen, either NPH or insulin glargine can serve as basal insulin: a randomized trial in hospitalized adults with type 2 diabetes, respiratory disease, and medium- to high-dose intermediate-acting corticosteroids found the two basal strategies equally effective within a basal-bolus protocol. [1][8]", "For long-acting dexamethasone or intermediate-acting methylprednisolone associated with hyperglycemia throughout the day, do not assume a single fasting measurement captures control. Use serial glucose results across the day to judge whether the current basal-bolus exposure covers the sustained pattern. [13][22]" ], "bullets": [ "Avoid correction-only thinking when elevations persist: the Endocrine Society guideline recommends insulin therapy for persistent hyperglycemia during glucocorticoid treatment. [11]", "If selecting NPH versus glargine as basal insulin in a hospitalized patient with type 2 diabetes receiving intermediate-acting corticosteroids, recognize that trial evidence found similar efficacy when both were used as part of basal-bolus therapy. [8]", "Evaluate each insulin change against the actual steroid dose and timing, not against fasting glucose alone. [1][18]" ], "subsections": [ { "heading": "When noninsulin agents are considered", "paragraphs": [ "For mild steroid-induced hyperglycemia, metformin or gliclazide have been used; DPP-4 inhibitor or GLP-1 receptor agonist therapy may be considered second line when pancreatitis and elevated lipase are absent. Moderate to severe hyperglycemia requires insulin therapy matched to steroid dose and pharmacodynamic profile. [1]" ], "bullets": [ "Do not allow consideration of oral or incretin-based therapy to delay insulin when hyperglycemia is moderate to severe, persistent, or accompanied by acute illness. [1][11]" ] } ], "table": { "caption": "Insulin strategy selection by observed steroid-associated glucose pattern. [1][8][11][13][22]", "columns": [ "Pattern", "Insulin approach", "Key tradeoff or reassessment point" ], "rows": [ [ "Persistent hyperglycemia during any glucocorticoid regimen", "Start scheduled insulin therapy. [11]", "Review point-of-care glucose trends and glucocorticoid changes frequently. [1][12]" ], [ "Morning steroid regimen with delayed daytime hyperglycemia", "Use morning intermediate-acting isophane/NPH insulin or morning mixed insulin matched to the steroid profile. [1]", "Fasting glucose can be misleadingly normal; use postprandial readings to titrate. [18][22]" ], [ "Hospitalized type 2 diabetes receiving medium- or high-dose intermediate-acting corticosteroids", "NPH or glargine may be used as basal insulin within basal-bolus treatment. [8]", "The randomized trial found equal efficacy; choose according to regimen fit and monitoring capability. [8]" ], [ "Longer-duration hyperglycemic effect across the day", "Assess a basal-bolus strategy against serial daytime glucose values. [13][22]", "Do not base adequacy solely on fasting glucose. [22]" ] ] } }, { "id": "taper-and-transition-safety", "eyebrow": "Safety", "heading": "Down-titrate insulin when steroid exposure falls", "intro": "The highest preventable risk after achieving control is hypoglycemia during steroid tapering or cessation.", "paragraphs": [ "Whenever glucocorticoids are substantially reduced, reassess the diabetes regimen at the same time. Steroids are the principal driver of the added insulin requirement, and failure to lower glucose-lowering therapy as steroid exposure decreases is a frequent cause of hypoglycemia. [1]", "At discharge or during outpatient steroid adjustment, give the patient a glucose-monitoring plan, hypoglycemia education if insulin or another hypoglycemia-producing therapy is used, and explicit instructions to contact the treating team when steroid dosing changes. Education should include symptoms of severe hyperglycemia and thresholds for hospital presentation. [1]", "Patients with preexisting diabetes require particular attention because glucocorticoids can worsen existing hyperglycemia, while patients without known diabetes may have unmasked diabetes or transient steroid-related dysglycemia. Continued follow-up should therefore be guided by glucose trajectory after steroid withdrawal and baseline HbA1c when available. [18][1]" ], "bullets": [ "Link every steroid prescription renewal, taper instruction, or discontinuation order to a review of insulin and other glucose-lowering medications. [1]", "Teach patients using insulin how to recognize and manage hypoglycemia before outpatient dose adjustments are made. [1]", "Escalate urgently rather than attempting routine outpatient titration when glucose and ketone thresholds indicate ketoacidosis or hyperosmolar risk. [1]" ], "subsections": [], "table": { "caption": "Transition rules for insulin-treated steroid-induced hyperglycemia. [1][18]", "columns": [ "Transition event", "Required action", "Safety rationale" ], "rows": [ [ "Substantial steroid dose reduction", "Review and down-titrate glucose-lowering therapy. [1]", "Insulin requirement can fall rapidly enough to cause hypoglycemia if doses are unchanged. [1]" ], [ "Steroid discontinuation", "Continue glucose surveillance and reassess whether ongoing diabetes treatment is needed. [1][18]", "Hyperglycemia may resolve, persist as unmasked diabetes, or reflect preexisting diabetes. [18]" ], [ "Outpatient insulin initiation or adjustment", "Provide glucose-monitoring, severe-hyperglycemia, and hypoglycemia education. [1]", "Both hyperglycemic crisis and treatment-related hypoglycemia require patient recognition and prompt action. [1]" ] ] } } ], "faq": [], "references": [ { "number": 1, "title": "Hyperglycemia in patients treated with immune checkpoint inhibitors: key clinical challenges and multidisciplinary consensus recommendations | Journal for ImmunoTherapy of Cancer", "detail": "jitc.bmj.com", "url": "https://jitc.bmj.com/content/13/6/e011271", "authors": "jitc.bmj.com", "host": "jitc.bmj.com" }, { "number": 2, "title": "Management of diabetes and hyperglycaemia in the hospital", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(20)30381-8.pdf", "authors": "www.thelancet.com", "host": "www.thelancet.com" }, { "number": 3, "title": "Fresh insights into glucocorticoid-induced diabetes mellitus and new ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41574-022-00683-6", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 4, "title": "COVID-19 and diabetes mellitus: from pathophysiology to clinical management | Nature Reviews Endocrinology", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41574-020-00435-4", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 5, "title": "Management of Glucocorticoid‐Induced Diabetes and/or Hyperglycemia - Endocrine and Metabolic Medical Emergencies - Wiley Online Library", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/9781119374800.ch38", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 6, "title": "Glucocorticoid-Induced Hyperglycemia in Oncologic Outpatients: A Narrative Review Using the Quadruple Aim Framework - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1499267122000235", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 7, "title": "Glucocorticoid-Induced Hyperglycemia in Patients With Cancer: Mechanisms, Clinical Implications, and Management Strategies - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1530891X26000418", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 8, "title": "Randomized clinical trial of the efficacy and safety of insulin glargine vs. NPH insulin as basal insulin for the treatment of glucocorticoid induced hyperglycemia using continuous glucose monitoring in hospitalized patients with type 2 diabetes and respiratory disease - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0168822715003952#!", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 9, "title": "Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? 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Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Hyperglycemia in patients treated with immune checkpoint inhibitors: key clinical challenges and multidisciplinary consensus recommendations | Journal for ImmunoTherapy of Cancer", "detail": "jitc.bmj.com", "url": "https://jitc.bmj.com/content/13/6/e011271", "authors": "jitc.bmj.com", "host": "jitc.bmj.com", "snippet": "#### Management\n\nAll patients with steroid-induced hyperglycemia should receive education regarding glucose monitoring, symptoms of severe hyperglycemia, and safety thresholds for presentation to the hospital. Those receiving glucose-lowering therapy, which may induce low BGLs, should also be educat", "score": 0.6877354 }, { "number": 2, "title": "Management of diabetes and hyperglycaemia in the hospital", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(20)30381-8.pdf", "authors": "www.thelancet.com", "host": "www.thelancet.com", "snippet": "“inpatient”, “hospitalized”, “hyperglycaemia”, “hyperglycemia”, “hypoglycaemia”, \n\n“hypoglycemia”, “incretin therapy”, “metformin”, “sulfonylurea”, “thiazolidinedione”, \n\n“SGLT-2”, “GLP-1”, “DPP-4 inhibitor”, “insulin”, “basal bolus”, “enteral nutrition”, \n\n“parenteral nutrition”, “corticosteroids”,", "score": 0.3384274 }, { "number": 3, "title": "Fresh insights into glucocorticoid-induced diabetes mellitus and new ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41574-022-00683-6", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Article \nCAS \nPubMed \nGoogle Scholar\n\nRoberts, A., James, J. & Dhatariya, K., Joint British Diabetes Societies for Inpatient Care. Management of hyperglycaemia and steroid (glucocorticoid) therapy: a guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group. Diabet. Med. 35", "score": 0.78963995 }, { "number": 4, "title": "COVID-19 and diabetes mellitus: from pathophysiology to clinical management | Nature Reviews Endocrinology", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41574-020-00435-4", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "CAS \nPubMed \nPubMed Central \nGoogle Scholar\n\nBonaventura, A. & Montecucco, F. Steroid-induced hyperglycemia: an underdiagnosed problem or clinical inertia? A narrative review. Diabetes Res. Clin. Pract. 139, 203–220 (2018).\n\nCAS \nPubMed \nGoogle Scholar\n\nTomazini, B. M. et al. Effect of dexamethasone", "score": 0.51193684 }, { "number": 5, "title": "Management of Glucocorticoid‐Induced Diabetes and/or Hyperglycemia - Endocrine and Metabolic Medical Emergencies - Wiley Online Library", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/9781119374800.ch38", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "## Management of Glucocorticoid-Induced Diabetes and/or Hyperglycemia. The prevalence of oral glucocorticoid use in the general population is approximately 1%, with higher rates observed in older adults, and chronic use (≥5 years) in nearly one-third of patients. Despite their beneficial effects, gl", "score": 0.79883134 }, { "number": 6, "title": "Glucocorticoid-Induced Hyperglycemia in Oncologic Outpatients: A Narrative Review Using the Quadruple Aim Framework - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1499267122000235", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### JAMA Oncol\n\n### Metformin's effectiveness in preventing prednisone-induced hyperglycemia in hematological cancers\n\n### J Oncol Pharm Pract\n\n### Joint British Diabetes Societies (JBDS) for Inpatient Care. Management of hyperglycaemia and steroid (glucocorticoid) therapy: A guideline from the Join", "score": 0.76512027 }, { "number": 7, "title": "Glucocorticoid-Induced Hyperglycemia in Patients With Cancer: Mechanisms, Clinical Implications, and Management Strategies - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1530891X26000418", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### J Transl Int Med\n\n### A practical guide for the management of steroid induced hyperglycaemia in the hospital\n\n### J Clin Med\n\n### A guideline for the outpatient management of glycaemic control in people with cancer\n\n### Diabetic Med\n\n### The 2021–2022 position of Brazilian diabetes society on in", "score": 0.72395444 }, { "number": 8, "title": "Randomized clinical trial of the efficacy and safety of insulin glargine vs. NPH insulin as basal insulin for the treatment of glucocorticoid induced hyperglycemia using continuous glucose monitoring in hospitalized patients with type 2 diabetes and respiratory disease - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0168822715003952#!", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: Randomized clinical trial of the efficacy and safety of insulin glargine vs. NPH insulin as basal insulin for the treatment of glucocorticoid induced hyperglycemia using continuous glucose monitoring in hospitalized patients with type 2 diabetes and respiratory disease - ScienceDirect\nNPH ins", "score": 0.6917478 }, { "number": 9, "title": "Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? A narrative review - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0168822717319368", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Diabetes Res Clin Pract\n\n### Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial\n\n### Lancet\n\n### New-onset diabetes after transplantation: results from a double-blind early corticosteroid withdrawal trial\n\n", "score": 0.6636041 }, { "number": 10, "title": "Glucocorticoid-induced hyperglycemia in... : The Egyptian Journal of Haematology", "detail": "journals.lww.com", "url": "https://journals.lww.com/egjh/fulltext/2020/45030/glucocorticoid_induced_hyperglycemia_in.2.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "The prevalence of hyperglycemia in the course of steroid administration ranges according to various authors from 16 to 35% in patients with hematological diseases. Mechanisms for glucocorticoid-induced hyperglycemia include alteration of insulin sensitivity in the peripheral tissue and promotion of ", "score": 0.528461 }, { "number": 11, "title": "An Endocrine Society Clinical Practice Guideline - Oxford Academic", "detail": "academic.oup.com", "url": "https://academic.oup.com/jcem/article/97/1/16/2833111", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "We recommend that insulin therapy be initiated for patients with persistent hyperglycemia while receiving glucocorticoid therapy. In general, discontinuation", "score": 0.32015187 }, { "number": 12, "title": "Management of Hyperglycemia in Hospitalized Patients in Non ...", "detail": "academic.oup.com", "url": "https://academic.oup.com/jcem/article-pdf/97/1/16/20288218/jcem0016.pdf", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "We recommend that bedside POC testing be ini- tiated for patients with or without a history of diabetes receiving glucocorticoid therapy.", "score": 0.20885621 }, { "number": 13, "title": "The Impact of Insulin Degludec on... : Journal of Diabetology", "detail": "journals.lww.com", "url": "https://journals.lww.com/jodb/fulltext/2024/15020/the_impact_of_insulin_degludec_on.6.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Glucocorticoids are prescribed as SOC in moderate-to-severe COVID-19 as they reduce the risk of mortality.[8-10] The World Health Organization recommends the use of dexamethasone or prednisone or hydrocortisone for a period of 10 days in moderate-to-severe COVID-19. The Indian Council of Medical Res", "score": 0.6625569 }, { "number": 14, "title": "Glucocorticoid-induced hyperglycemia - PubMed", "detail": "www.ncbi.nlm.nih.gov", "url": "http://www.ncbi.nlm.nih.gov/pubmed/23531958", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Title: Glucocorticoid-induced hyperglycemia - PubMed\nClipboard, Search History, and several other advanced features are temporarily unavailable. Skip to main page content. An official website of the United States government. **The .gov means it’s official.**. Federal government websites often end in", "score": 0.7724109 }, { "number": 15, "title": "1104-P: Management of Corticosteroid-Related Hospital ...", "detail": "diabetesjournals.org", "url": "https://diabetesjournals.org/diabetes/article/68/Supplement_1/1104-P/58584/1104-P-Management-of-Corticosteroid-Related", "authors": "diabetesjournals.org", "host": "diabetesjournals.org", "snippet": "Jun 1, 2019 — Guidelines recommend basal bolus insulin for inpatient hyperglycemia management based on studies performed in patients with type 2 diabetes ...Read more", "score": 0.6016175 }, { "number": 16, "title": "A Novel Algorithm for the Management of Inpatient COVID-19 ...", "detail": "diabetesjournals.org", "url": "https://diabetesjournals.org/clinical/article/41/3/378/148554/A-Novel-Algorithm-for-the-Management-of-Inpatient", "authors": "diabetesjournals.org", "host": "diabetesjournals.org", "snippet": "Mar 2, 2023 — This article reports on a novel insulin titration protocol for the management of glucocorticoid-induced hyperglycemia in hospitalized patients ...Read more", "score": 0.5382315 }, { "number": 17, "title": "Metformin for Glucocorticoid-Induced Toxicity: Why Not?", "detail": "diabetesjournals.org", "url": "https://diabetesjournals.org/care/article/48/5/688/158152/Metformin-for-Glucocorticoid-Induced-Toxicity-Why", "authors": "diabetesjournals.org", "host": "diabetesjournals.org", "snippet": "Apr 24, 2025 — Meta-analyses suggest that >1 month of glucocorticoid treatment associates with hyperglycemia in 32% of people without preexisting diabetes (6).Read more", "score": 0.27445027 }, { "number": 18, "title": "Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem - PMC", "detail": "www.ncbi.nlm.nih.gov", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/5503862", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Title: Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem - PMC\nGlucocorticoids exacerbate hyperglycemia in patients with diabetes mellitus, unmask undiagnosed diabetes mellitus or may precipitate the appearance of GIDM, which is an independent risk factor for other compli", "score": 0.5709301 }, { "number": 19, "title": "Use of NPH versus Basal Bolus Insulin for Steroid Induced ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/21/NCT03511521/Prot_SAP_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov", "snippet": "Exclusion Criteria:  Patient’s with two or more doses of methylprednisolone/prednisone per day or other steroids, such as hydrocortisone or dexamethasone  Pregnancy  eGFR < 45 ml/min/1.73m2 STUDY TIMELINES: Once a participant is recruited for the study, participants will be followed for three day", "score": 0.69099766 }, { "number": 20, "title": "Pathways to Quality Inpatient Management of Hyperglycemia and Diabetes: A Call to Action | Diabetes Care | American Diabetes Association", "detail": "diabetesjournals.org", "url": "https://diabetesjournals.org/care/article/36/7/1807/33203/Pathways-to-Quality-Inpatient-Management-of", "authors": "diabetesjournals.org", "host": "diabetesjournals.org", "snippet": "Title: Pathways to Quality Inpatient Management of Hyperglycemia and Diabetes: A Call to Action | Diabetes Care | American Diabetes Association\nFuture clinical trials will allow practitioners to develop optimal approaches for the management of hyperglycemia in the hospitalized patient and lessen the", "score": 0.42605945 }, { "number": 21, "title": "What is the optimal time for measuring glucose concentration to detect steroid-induced hyperglycemia in patients with rheumatic diseases? - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0009912019301195", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Allergy, Asthma Clin. Immunol.\n\n### Impaired glucose handling in active rheumatoid arthritis: effects of corticosteroids and antirheumatic treatment\n\n### Metab. Clin. Exp.\n\n### EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therap", "score": 0.57780564 }, { "number": 22, "title": "Insulin Dosing and Glycemic Outcomes Among Steroid-treated Hospitalized Patients", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1530891X22005006", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "## Introduction\n\nGlucocorticoids (steroids) are medications that are commonly used to treat a variety of conditions through immunosuppressive and anti-inflammatory mechanisms. Although clinically useful, steroids are associated with several side effects, including hyperglycemia.1 Steroid-associated ", "score": 0.44044575 }, { "number": 23, "title": "Glucocorticoid-Induced Hyperglycemia - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1530891X20411711", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### J Clin Invest.\n\n### (American Diabetes Association Diabetes in Hospitals Writing Committee). Management of diabetes and hyperglycemia in hospitals [published corrections appear in Diabetes Care. 2004;27:856 and Diabetes Care. 2004;27:1255]\n\n### Diabetes Care.\n\n### Risk of diabetes associated wit", "score": 0.37079534 }, { "number": 24, "title": "[PDF] Steroid-induced hyperglycemia - ScienceDirect.com", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/am/pii/S0168822717319368", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "The classical definition of SIDM refers to as an abnormal increase in blood glucose (BG) concentration during glucocorticoid use in patients with or without a", "score": 0.35555163 } ], "publishedAt": "2026-09-15T18:28:18.342729+00:00", "updatedAt": "2026-09-15T18:28:18.342729+00:00", "readingMinutes": 5, "slug": "steroid-induced-hyperglycemia" }