Systemic treatment with glucocorticoids is associated with incident hypoglycemia and mortality: A historical prospective analysis.
Am J Med. 2020 Jan 23;:
Authors: Khanimov I, Boaz M, Shimonov M, Wainstein J, Leibovitz E
PURPOSE: To examine whether the increased glycemic variability associated with systemic glucocorticoid treatment is also associated with increased incidence of hypoglycemia.
METHODS: In this retrospective analysis were included all patients discharged from internal medicine units between 2010 and 2013. Patients were assigned to 3 groups: Group 1: No steroids were prescribed. Group 2: Topical or inhaled steroids with no systemic treatment. Group 3: Systemic steroids were prescribed, with or without topical or inhaled treatment.
RESULTS: A total of 45,272 patients were included in the study. Patients in Group 3 had significantly higher rates of hypoglycemia (10.9%) compared to patients in Group 2 (7.4%), and patients in Group 1 (7.3%). Patients with diabetes mellitus had higher rates of hypoglycemia compared to patients without diabetes mellitus (14.3% vs. 4.9%), but exhibited similar trends in response to steroid treatment. Multivariate analysis showed that systemic steroids were associated with increased risk for hypoglycemia (OR 1.513, 95% CI 1.311- 1.746, p<0.001). Hypoglycemia associated with systemic steroid treatment was also associated with increased risk of death (HR 2.328, 95% CI 1.931- 2.807, p <0.001). Patients who were treated with systemic steroids but did not have hypoglycemia did not have higher mortality rates (HR 1.068, 95% CI 0.972- 1.175, p=0.171).
CONCLUSION: Treatment with systemic steroid is associated with increased hypoglycemia incidence during hospitalization. Patients treated with steroids that had incident hypoglycemia had higher one-year mortality risk compared to steroid-treated patients without hypoglycemia.
PMID: 31982493 [PubMed - as supplied by publisher]