Abstract
Aims
The optimal treatment of prednisolone-associated hyperglycaemia is unclear, but guidelines
recommend using a body weight-based daily insulin dose. This study evaluated how clinical
variables were associated with insulin requirements in hospitalised patients with
prednisolone-associated hyperglycaemia.
Methods
In this prospective study, fifty adult inpatients who were taking prednisolone ≥20 mg/day
and experienced hyperglycaemia were prescribed a 24-h intravenous insulin infusion.
The daily insulin dose required to attain a mean glucose of 8 mmol/L was calculated.
The associations between daily insulin dose and clinical variables were assessed.
Results
The participants age was 69 ± 10 years, daily prednisolone dose was 34 ± 10 mg, HbA1c
was 7.7 ± 2.0 % (61 ± 10 mmol/mol), 77 % had known type 2 diabetes and 30 % were female.
In univariate analysis, weight was associated with daily insulin dose (r2 = 0.11, p = 0.024). A multivariate model comprising sex, HbA1c, a prior diagnosis
of diabetes, diabetes treatment and weight explained nearly-two thirds of the variability
in daily insulin dose (r2 = 0.65, p < 0.001).
Conclusions
In patients with prednisolone-associated hyperglycaemia, calculating insulin doses
based on sex, HbA1c, diabetes status and regular diabetes treatment and weight may
improve glycaemic control compared to weight-based dosing.
Keywords
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Article info
Publication history
Published online: February 01, 2023
Accepted:
January 27,
2023
Received in revised form:
January 19,
2023
Received:
August 31,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
