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Use of parenteral glucocorticoids and the risk of new onset type 2 diabetes mellitus: A case-control study

  • Ala Keyany
    Affiliations
    Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands
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  • Johannes T.H. Nielen
    Affiliations
    Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands

    Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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  • Patrick C. Souverein
    Affiliations
    Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
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  • Frank de Vries
    Correspondence
    Corresponding author at: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, The Netherlands.
    Affiliations
    Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands

    Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands

    Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, Netherlands
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  • Bart van den Bemt
    Affiliations
    Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands

    Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands
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Published:February 22, 2018DOI:https://doi.org/10.1016/j.diabres.2018.02.010

      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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