A study has found that even short-term use of oral corticosteroids can increase the risk of serious complications, including gastrointestinal bleeding, pneumonia and heart failure, in people with diabetes.
Corticosteroids are medications made from synthetic versions of cortisol, the stress hormone secreted by the adrenal glands. They are often taken at high doses for short periods to provide immediate relief when allergies or asthma attacks occur. While they rapidly reduce inflammation, previous studies have shown that they increase insulin resistance and reduce insulin production and secretion, affecting blood glucose homeostasis. Accordingly, medical guidelines recommend closely monitoring sharp rises in blood glucose when prescribing short-term oral corticosteroid therapy to people with diabetes. However, it had not been established whether the treatment causes risks beyond elevated blood glucose, prompting this follow-up study.
A research team from the College of Medicine at Chang Gung University and Chang Gung Memorial Hospital in Taiwan analyzed the effects of oral corticosteroid use in people with diabetes using data from Taiwan's National Health Insurance Research Database. The analysis included 36,048 adults with diabetes.
The analysis found that three health emergencies rose sharply within one month of starting intensive steroid treatment. Compared with nonusers, steroid users had a 1.71-fold higher risk of gastrointestinal bleeding, a 2.06-fold higher risk of pneumonia and a 1.87-fold higher risk of heart failure. Although the risks declined over time, they remained substantial. Between one and three months after steroid treatment ended, the risk of gastrointestinal bleeding was 1.26 times higher, while the risk of fractures was 1.42 times higher.
Dr. Yao Zhongqi, who led the study, said, "These findings do not mean that doctors should stop oral corticosteroid treatment. Rather, they suggest that doctors should carefully weigh the risks and benefits when prescribing the treatment to high-risk patients, taking the complication risk figures into account." The research team plans to conduct additional studies involving larger populations to establish clear guidelines that clinicians can follow when prescribing corticosteroids to people with diabetes.
Meanwhile, the findings were recently published in the international academic journal JAMA Network Open.
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Corticosteroids are medications made from synthetic versions of cortisol, the stress hormone secreted by the adrenal glands. They are often taken at high doses for short periods to provide immediate relief when allergies or asthma attacks occur. While they rapidly reduce inflammation, previous studies have shown that they increase insulin resistance and reduce insulin production and secretion, affecting blood glucose homeostasis. Accordingly, medical guidelines recommend closely monitoring sharp rises in blood glucose when prescribing short-term oral corticosteroid therapy to people with diabetes. However, it had not been established whether the treatment causes risks beyond elevated blood glucose, prompting this follow-up study.
A research team from the College of Medicine at Chang Gung University and Chang Gung Memorial Hospital in Taiwan analyzed the effects of oral corticosteroid use in people with diabetes using data from Taiwan's National Health Insurance Research Database. The analysis included 36,048 adults with diabetes.
The analysis found that three health emergencies rose sharply within one month of starting intensive steroid treatment. Compared with nonusers, steroid users had a 1.71-fold higher risk of gastrointestinal bleeding, a 2.06-fold higher risk of pneumonia and a 1.87-fold higher risk of heart failure. Although the risks declined over time, they remained substantial. Between one and three months after steroid treatment ended, the risk of gastrointestinal bleeding was 1.26 times higher, while the risk of fractures was 1.42 times higher.
Dr. Yao Zhongqi, who led the study, said, "These findings do not mean that doctors should stop oral corticosteroid treatment. Rather, they suggest that doctors should carefully weigh the risks and benefits when prescribing the treatment to high-risk patients, taking the complication risk figures into account." The research team plans to conduct additional studies involving larger populations to establish clear guidelines that clinicians can follow when prescribing corticosteroids to people with diabetes.
Meanwhile, the findings were recently published in the international academic journal JAMA Network Open.
✔ Get answers to your diabetes questions in one place.
From delicious, convenient meal plans to exercises for managing blood glucose levels!
Sign up now for a free subscription to Mildang365.