STEROID-INDUCED GLYCEMIC ALTERATIONS IN DIABETIC PATIENTS: A SYSTEMIC LITERATURE REVIEW

Ariya Krishna R. V.*, Dr. Prasobh G. R., Dr. Nithin Manohar R., Dr. Padmesh P. R., Athira R. B., Afin A. R., Gokul G.

ABSTRACT

Glucocorticoids are commonly prescribed for the management of inflammatory, autoimmune, and respiratory diseases because of their potent anti-inflammatory and immunosuppressive properties. Despite their therapeutic benefits, corticosteroids are associated with significant metabolic adverse effects, particularly steroid-induced hyperglycaemia and glucocorticoid- induced diabetes mellitus. Corticosteroids impair glucose homeostasis by increasing hepatic gluconeogenesis, reducing peripheral glucose uptake, inducing insulin resistance in skeletal muscle and adipose tissue, and suppressing pancreatic β-cell insulin secretion. These effects predominantly cause postprandial hyperglycaemia, especially during the afternoon and evening after morning glucocorticoid administration. This systematic literature review evaluates the glycaemic status of diabetic patients with respiratory infections undergoing corticosteroid therapy. Respiratory conditions such as community-acquired pneumonia, chronic obstructive pulmonary disease, asthma, and interstitial lung disease frequently require glucocorticoid treatment, thereby increasing the risk of hyperglycaemia. Regular monitoring of fasting and postprandial blood glucose levels is essential for early detection and prevention of complications. Risk factors include advanced age, obesity, family history of diabetes, higher steroid doses, and prolonged duration of therapy. Management strategies involve lifestyle modifications, oral antidiabetic agents, and insulin therapy, particularly NPH insulin for intermediate-acting glucocorticoids. Early assessment and proper glycaemic management are important to reduce morbidity, hospital stay, and infection-related complications in diabetic patients receiving corticosteroid therapy.

Keywords: Glucocorticoids – Steroid -Induced Hyperglycaemia -Diabetes Mellitus – Blood Glucose Monitoring.