Glucocorticoid-induced hyperglycemia
Por:
Perez, A, Jansen-Chaparro, S, Saigi, I, Bernal-Lopez, MR, Minambres, I, Gomez-Huelgas, R
Publicada:
1 ene 2014
Resumen:
Corticosteroid-induced hyperglycemia is a common medical problem that can lead to frequent emergency room visits, hospital admissions and prolonged hospital stay, in addition to the well known morbidity associated with hyperglycemia. However, the diagnosis and treatment of corticosteroid-induced hyperglycemia is surprisingly undervalued by most professionals, probably because of the lack of quality studies to determine specific strategies of action. In the present review, we discuss the pathophysiology of corticosteroid-induced hyperglycemia, focusing on diverse patterns of hyperglycemia induced by the different formulations, and provide clues for diagnosis based on the duration of treatment and the administration schedule of corticosteroids. We propose a treatment strategy based on both the pathophysiology of the process and the mechanism of action of different corticosteroids, and take into account dosing and administration timing to predict the duration of therapy. Finally, we propose treatment goals that differ slightly between the transient and continuous use of corticosteroids based on evidence from clinical practice guidelines of diabetes care both in ambulatory and hospital settings.
Filiaciones:
Perez, A:
Hosp Santa Creu & Sant Pau, Endocrinol & Nutr Dept, Barcelona 08025, Spain
Consorci Hosp Vic, CIBER Diabet & Metab Dis CIBERDEM, Barcelona, Spain
Jansen-Chaparro, S:
Hosp Carlos Haya, Dept Internal Med, Malaga, Spain
Saigi, I:
Consorci Hosp Vic, Endocrinol & Nutr Unit, Barcelona, Spain
Bernal-Lopez, MR:
Hosp Virgen Victoria, CIBER Physiopathol Obes & Nutr CIBEROBN, Malaga, Spain
Hosp Virgen Victoria, Dept Endocrinol, Biomed Res Lab, Malaga, Spain
Minambres, I:
Hosp Santa Creu & Sant Pau, Endocrinol & Nutr Dept, Barcelona 08025, Spain
Gomez-Huelgas, R:
Hosp Carlos Haya, Dept Internal Med, Malaga, Spain
Hosp Virgen Victoria, CIBER Physiopathol Obes & Nutr CIBEROBN, Malaga, Spain
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