An open comparision of the diabetogenic effect of deflazacort and prednisone at a dosage ratio of 1.5 mg : 1 mg

Objective: To compare the diabetogenic effects of deflazacort (D) versus pr ednisone (PN) using a dosage ratio of 1.5 mg deflazacort: I mg prednisone, Methods: Thirty-three patients suffering from various active connective tis sue or chronic inflammatory diseases were randomized to be treated with D o r PN, assuming a therapeutic equipotency ratio of 1.5 mg D:1 mg PN. Neither dosage nor glucocorticoid employed were modified during the study. Patient s had not received steroid treatment during the month prior to their inclus ion date. Fasting glucose, glycosilated haemoglobin and fructosamine were d etermined before and after 1 month of treatment, Non-diabetic patients were also submitted to an oral glucose tolerance test (OGTT) at entry and after 1 month. Results were compared by univariate, and multivariate tests to co rrect the effects of age, body mass index and diagnosis. Results: After 1 month of treatment there were no differences between D and PN in fasting glucose, glycosilated haemoglobin, or fructosamine. OGTT per formed after treatment showed similar glucose values for both treatment gro ups. Patients treated with D had insulin levels at min 60 of the post-treat ment OGTT which were higher than those treated with PN [114.1 (62.8) mcUI . ml(-1) versus 73.5 (32.7) mcUI . ml(-1), P = 0.049], but the difference lo st its statistical significance in the multivariate analysis. Conclusion: D and PN have similar effects on glucose tolerance when an equi potency ratio of 1.5 mg D:1 mg PN is employed. Previous studies employing a ratio of 1.2. 1 mg may have understimated the adverse effects of D on gluc ose metabolism.