Aberer Felix, Hochfellner Daniel A, Sourij Harald, Mader Julia K
Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.
Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8036 Graz, Austria.
J Clin Med. 2021 May 16;10(10):2154. doi: 10.3390/jcm10102154.
Glucocorticoids represent frequently recommended and often indispensable immunosuppressant and anti-inflammatory agents prescribed in various medical conditions. Despite their proven efficacy, glucocorticoids bear a wide variety of side effects among which steroid induced hyperglycaemia (SIHG) is among the most important ones. SIHG, potentially causes new-onset hyperglycaemia or exacerbation of glucose control in patients with previously known diabetes. Retrospective data showed that similar to general hyperglycaemia in diabetes, SIHG in the hospital and in outpatient settings detrimentally impacts patient outcomes, including mortality. However, recommendations for treatment targets and guidelines for in-hospital as well as outpatient therapeutic management are lacking, partially due to missing evidence from clinical studies. Still, SIHG caused by various types of glucocorticoids is a common challenge in daily routine and clinical guidance is needed. In this review, we aimed to summarize clinical evidence of SIHG in inpatient care impacting clinical outcome, establishment of diagnosis, diagnostic procedures and therapeutic recommendations.
糖皮质激素是各类医疗状况下常用且往往不可或缺的免疫抑制剂和抗炎药。尽管其疗效已得到证实，但糖皮质激素有多种副作用，其中类固醇诱导的高血糖症（SIHG）是最重要的副作用之一。SIHG可能导致既往已知糖尿病患者出现新发高血糖症或血糖控制恶化。回顾性数据显示，与糖尿病患者的一般高血糖症类似，医院和门诊环境中的SIHG会对患者预后产生不利影响，包括死亡率。然而，目前缺乏关于治疗目标的建议以及住院和门诊治疗管理的指南，部分原因是临床研究缺乏证据。尽管如此，各类糖皮质激素引起的SIHG仍是日常医疗中的常见挑战，需要临床指导。在本综述中，我们旨在总结住院治疗中SIHG影响临床结局、诊断确立、诊断程序及治疗建议的临床证据。
