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[大剂量治疗期间糖皮质激素诱导的糖尿病及危险因素]

[Glucocorticoid-induced diabetes and risk factors during high-dose therapy].

作者信息

Patel Dustin Andersen, Kristensen Peter Lommer, Pedersen-Bjergaard Ulrik, Schultz Helga Holm

出版信息

Ugeskr Laeger. 2018 Apr 30;180(18).

Abstract

This review describes the cumulative incidence (CI) and risk factors of glucocorticoid (GC)-induced diabetes in patients commencing high-dose GC therapy: ≥ 30 mg prednisolone/day. Finally, methods of screening are discussed. In 13 studies, the CI of GC-induced diabetes ranges 12-65%, but with the current diagnostic criteria the CI is assessed to be 30-50%. Risk factors may include high age and high levels of BMI and glycated haemoglobin, respectively, before GC therapy. It is important to acknowledge, that hyperglycaemia in GC therapy is more prevalent postprandially, and screening should be planned accordingly.

摘要

本综述描述了开始高剂量糖皮质激素(GC)治疗(≥30mg泼尼松龙/天)的患者中GC诱导糖尿病的累积发病率(CI)和危险因素。最后,讨论了筛查方法。在13项研究中,GC诱导糖尿病的CI范围为12%-65%,但根据当前诊断标准,CI估计为30%-50%。危险因素可能分别包括GC治疗前年龄较大、BMI和糖化血红蛋白水平较高。必须认识到,GC治疗中的高血糖在餐后更为普遍,因此应相应地安排筛查。

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