Pregledni rad

NEW INSIGHTS IN STEROID DIABETES

TINA TIČINOVIĆ KURIR ; Klinički zavod za kliničku patofiziologiju, KBC Split, Split, Hrvatska
JOŠKO BOŽIĆ ; Zavod za integrativnu fiziologiju, Medicinski fakultet Sveučilišta u Splitu, Split, Hrvatska
ANITA MARKOTIĆ ; Katedra za medicinsku kemiju i biokemiju, Medicinski fakultet Sveučilišta u Splitu, Split, Hrvatska
ANELA NOVAK ; Klinika za unutarnje bolesti, KBC Split, Split, Hrvatska

Sažetak

Glucocorticoids (GC) are the cornerstone in the treatment of numerous chronic autoimmune and inflammatory diseases. GC treatment is accompanied by significant metabolic adverse effects, including insulin resistance, glucose intolerance and diabetes, visceral adiposity, dyslipidemia and skeletal muscle atrophy. GCs are the most common cause of drug-induced diabetes mellitus. However, not everyone treated with glucocorticoids develops diabetes. Predictors of development of diabetes are age, weight, family history of diabetes mellitus, or personal history of gestational diabetes. There is evidence that patients with decreased insulin secretory reserve are much more likely to develop diabetes. Diabetes from topical steroid use is uncommon, but high-dose steroids have been associated with significant hyperglycemia, including development of hyperglycemic hyperosmolar syndrome and even diabetic ketoacidosis in patients with type 1 diabetes mellitus. Several mechanisms contribute to the development of hyperglycemia and steroid-induced diabetes, including decreased peripheral insulin sensitivity, increased hepatic glucose production, and inhibition of pancreatic insulin production and secretion. Physicians treating patients with GCs should be aware of the induction of metabolic disturbances and should not solely rely on fasting measurements. In addition, our review indicates that insulin therapy could be considered when treating patients on GC therapy.

Ključne riječi

glukokortikoidi; steroidni dijabetes; hiperglikemija; inzulinska rezistencija

Hrčak ID:

104099

URI

https://hrcak.srce.hr/104099

Datum izdavanja:

20.6.2013.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.626 *