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Risk of Steroid-Induced Diabetes Quantified

Glucocorticoid (or steroid) therapy is a well-known risk factor for diabetes. But what dose, given how and for how long?  Dixon and colleagues from the The University of Manchester have quantified the risk of diabetes associated with steroid use.  (Citation source

Overall they found a 30-60% increased risk of diabetes with steroid use. The risk was greatest with current/recent steroid use compared to long term steroid use. Whereas doses less than 5 mg per day had very little risk of diabetes, 5 mg of prednisolone equivalent dose for the last 1, 3, and 6 months was significantly associated with HRs of 1.20, 1.43, and 1.48, respectively, compared to nonusers.

Patients taking much higher doses (30 mg qd) were associated with an even greater risk, ranging from a 3-fold to 10-fold risk of DM if taken for 1, 3 or 6 months. They also found that glucocorticoids were associated with one new case of diabetes for every 150-200 people treated per year.

They correlated steroid doses with the risk of DM using rheumatoid arthritis patients from two different databases a UK primary care databases - the Clinical Practice Research Datalink [CPRD]) 21,962 RA patients) and the US National Data Bank for Rheumatic Diseases (NDB) 12,657 RA patients.



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