GLUCOCORTICOIDS AND THE RISK FOR INITIATION OF HYPOGLYCEMIC THERAPY

Citation
Jh. Gurwitz et al., GLUCOCORTICOIDS AND THE RISK FOR INITIATION OF HYPOGLYCEMIC THERAPY, Archives of internal medicine, 154(1), 1994, pp. 97-101
Citations number
18
Categorie Soggetti
Medicine, General & Internal
ISSN journal
00039926
Volume
154
Issue
1
Year of publication
1994
Pages
97 - 101
Database
ISI
SICI code
0003-9926(1994)154:1<97:GATRFI>2.0.ZU;2-6
Abstract
Purpose: To quantify risk for the occurrence of hyperglycemia requirin g initiation of hypoglycemic therapy in patients treated with oral glu cocorticoids. Patients and Methods: A case-control study of enrollees in the New Jersey Medicaid program 35 years of age or older. The 11855 case patients had newly initiated treatment with a hypoglycemic agent (oral or insulin) between 1981 and 1990. The 11855 controls represent ed a random sample of other Medicaid enrollees. Results: In patients u sing oral glucocorticoids, the estimated relative risk for development of hyperglycemia requiring treatment was 2.23 (95% confidence interva l, 1.92 to 2.59) as compared with nonusers. Risk increased with increa sing average daily steroid dose, in hydrocortisone-equivalent milligra ms; the odds ratio was 1.77 for 1 to 39 mg/d, 3.02 for 40 to 79 mg/d, 5.82 for 80 to 119 mg/d, and 10.34 for 120 mg/d or more. The estimated effects persisted after adjustment for a variety of potentially confo unding demographic, health service utilization, and medication use var iables. Conclusion: The findings of this population-based study quanti fy the risk of developing hyperglycemia requiring hypoglycemic therapy after oral glucocorticoid use. The magnitude of risk increases substa ntially with increasing glucocorticoid dose. These findings demonstrat e the utility of large-scale health claims databases in defining the r isk of important adverse drug effects.