Steroid Induced Diabetes

Corticosteroids are the synthetic analogue of adrenal cortex hormones which were discovered in the 1940s. Glucocorticoids are commonly used drugs in the inpatient and outpatient settings. Their use can cause steroidinduced hyperglycemia and steroid-induced diabetes. It is a common clinical problem with incidence as high as 46% of patients. It has preventable complications which increased both morbidity and mortality. Clinician should be alert to make proper screening especially for high risk population. The diagnosis of steroid induced diabetes is similar to diabetes mellitus. Management is challenging as there is limited evidence for variety of steroid regimens, variable glucose patterns and different patient factors. It starts with life style modifications to oral hypoglycemic agents and insulin. New medications for diabetes have very limited evidence to support their use. After stopping steroid, hyperglycemia usually normalized but may persist in some patients, so follow up is important to identify patients with persistent diabetes.