RISK-FACTORS FOR STEROID DIABETES IN RHEUMATIC PATIENTS

Background: Steroid induced diabetes (SDM) has been known for a long t ime, but its pathophysiological mechanisms as well as its predisposing factors remain unknown. Methods: In order to investigate the differen t factors related to the development of steroid diabetes (SDM) in pati ents,vith rheumatic diseases, we studied 27 patients with SDM, and 27 age- and sex-matched controls who also received therapy with glucocort icoids, In every case, family history of DM, body mass index, associat ed treatment, steroid dose and treatment duration were studied; fastin g serum insulin, ''C'' peptide, growth hormone and glucagon levels mer e measured. Results: All of the patients received prednisone. Cumulate d prednisone dose was the only factor significantly associated with th e development of SDM. Patients with SDM had a cumulated dose of 26.6 /- 28 g (M +/- SD), while the control group received 11.6 +/- 11 g (p< 0.02) (odds ratio, 6.35). Serum insulin levels were not significantly different, but insulin/glucose ratio was lower in SDM (0.104 +/- 0.05) than in the control group (0.163 +/- 0.07) (p<0.05). Conclusions: The se findings suggest that high cumulated prednisone dose may induce DM regardless of another hereditary or personal predisposing factor.