Abstract
Background
Use of oral glucocorticoids (GCs) has been associated with hyperglycaemia and type
2 diabetes mellitus (T2DM). However, unlike oral GCs, there is minimal or no data
on the effect of parenteral GC use on T2DM.
Objective
To assess the association between use of parenteral GCs and the risk of receiving
a first prescription of a non-insulin antidiabetic drug (NIAD) as a proxy for new
onset of T2DM.
Methods
A population based case-control study was performed using the Clinical Practice Research
Datalink (CPRD). Cases (n = 177,154) were defined as patients >18 years of age who
had their first ever NIAD prescription between January 1987 and October 2013. Controls
were matched by age, gender and general practitioner practice. Conditional logistic
regression analyses were used to estimate the risk of NIAD prescription and use of
parenteral GCs. Our analyses were statistically adjusted for lifestyle factors, comorbidities
and concomitant drug use.
Results
Although this study confirmed that oral GCs increases the risk of receiving a first
prescription of a NIAD (OR 2.63 [95% CI 2.53–2.73]), there was no association between
the use of parenterally administered GCs and the risk of receiving a first prescription
of a NIAD (OR 0.88 [95% CI 0.76–1.02]). The number of GC prescriptions was not associated
with risk of new onset T2DM compared to no parenteral GCs use; neither the type of
GC.
Conclusion
Our study does not demonstrate an association between the use of parenteral GCs and
the risk of new onset of T2DM.
Keywords
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References
- Risk of diabetes associated with prescribed glucocorticoids in a large population.Diabetes Care. 2006; 29: 2728-2729
- Glucocorticoid-induced hyperglycemia.Endocr Pract. 2009; 15: 469-474
- Quantification of the risk of corticosteroid-induced diabetes mellitus among the elderly.J Gen Intern Med. 2002; 17: 717-720
- Management of patients on chronic glucocorticoid therapy: an endocrine perspective.Prim Care. 2003; 30: 593-605
- Steroid hyperglycemia: prevalence, early detection and therapeutic recommendations: a narrative review.World J Diabetes. 2015 Jul 25; 6: 1073-1081
- Glucocorticoids and the risk for initiation of hypoglycemic therapy.Arch Intern Med. 1994 Jan 10; 154: 97-101
- Risk factors for the development of glucocorticoid-induced diabetes mellitus.Diabetes Res Clin Pract. 2015 May; 108: 273-279
- Glucocorticoid-induced diabetes mellitus: an important but overlooked problem.Endocrinol Metab. 2017 Jun; 32: 180-189
- Glucocorticoid treatment and endocrine pancreas function: implications for glucose homeostasis, insulin resistance and diabetes.J Endocrinol. 2014; 223: R49-R62
- Impact of glucocorticoid excess on glucose tolerance: clinical and preclinical evidence.Metabolites. 2016; 6 (Aug 3)
- Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis.Arthritis Rheum. 2011 Aug; 63: 2268-2275
- Glucose disturbances in non-diabetic patients receiving acute treatment with methylprednisolone pulses.Rev Assoc Med Bras. 2012; 58 (Jan-Feb): 125-128
- Increased blood glucose levels following intra-articular injection of methylprednisolone acetate in patients with controlled diabetes and symptomatic osteoarthritis of the knee.Ann Rheum Dis. 2008; 67: 1790-1791
- The effect of intra-articular injection of betamethasone acetate/betamethasone sodium phosphate on blood glucose levels in controlled diabetic patients with symptomatic osteoarthritis of the knee.Clin Rheumatol. 2009; 28: 85-87
- Systemic effects of epidural and intra-articular glucocorticoid injections in diabetic and non-diabetic patients.Joint Bone Spine. 2007; 74: 472-476
- Data resource profile: clinical practice research datalink (CPRD).Int J Epidemiol. 2015; 44: 827-836
- Drug-induced hyperglycemia.JAMA. 2001; 286: 1945-1948
- Serum methylprednisolone levels following intra-articular injection of methylprednisolone acetate.Ann Rheum Dis. 1981; 40: 571-574
- Plasma steroid levels after intra-articular injection of prednisolone acetate in patients with rheumatoid arthritis.Ann Rheum Dis. 1980; 39: 22-24
- Systemic effects of intra-articular corticosteroids.Clin Rheumatol. 2009; 28: 749-756
- Methylprednisolone pharmacokinetics after intravenous and oral administration.Br J Clin Pharmac. 1989; 27: 285-290
Health and social care information centre. Health Survey for England 2004, Health of Ethnic Minorities; 2006.
- Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African Caribbeans compared with Europeans. The Southall and Brent revisited (SABRE) cohort.Diabetes Care. 2012; 36: 383-393
Wikipedia (2016). Demography of United Kingdom. Retrieved August 23, 2016. https://en.wikipedia.org/wiki/Demography_of_the_United_Kingdom/.
- Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.J Rheumatol. 2006; 33: 2167-2172
Wijnands JM, van Durme CM, Driessen JH, Boonen A, Klop C, Leufkens B, et al. Individuals with type 2 diabetes mellitus are at an increased risk of gout but this is not due to diabetes: a population-based cohort study medicine (Baltimore). 2015;94(32):e1358.
- The risk of colorectal cancer in patients with type 2 diabetes: associations with treatment stage and obesity.Diabetes Care. 2015; 38: 495-502
- The risk of fracture in patients with multiple sclerosis: the UK general practice research database.J Bone Miner Res. 2011; 26: 2271-2279
Article info
Publication history
Published online: February 22, 2018
Accepted:
February 6,
2018
Received in revised form:
January 3,
2018
Received:
September 18,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
