[Disorder of glucose metabolism regulation in patients with multiple myeloma treated with high doses of corticosteroids at our clinic in 2004].

A deterioration of glucose tolerance is one of the most important side-effects ofglucocorticoid therapy. Disorders of glucose metabolism are present in almost all patients treated with glucocorticoids and 25% of these develop manifest diabetes mellitus. Glucocorticoids increase gluconeogenesis in hepatis and decrease insulinosensitivity in peripheral tissues and probably also decrease the release of insulin from pancreatic beta cells. The deterioration of glucose tolerance leads to worsening of morbidity and mortality of seriously ill patients. In glucocorticoid-induced diabetes mellitus the highest levels of glucose are seen in the afternoon, in the evening and postprandially: Normal levels of glucose are seen in the morning. Excluding 11 patients with diabetes (16%), we idenfied 7 (10%) patients with normal glucose tolerance, 13 (19%) patients with impaired fasting glucose or/and impaired glucose tolerance and glucocorticoid-induced diabetes mellitus we found in 37 (55%) patients treated in our department with diagnosis of myeloma multiplex in the year 2004 intermitently with 40 mg dexamethason p.o.