Corticosteroid-induced diabetes in palliative care.

J Palliat Med

Program of Palliative Care, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada.

Published: June 2012

AI Article Synopsis

  • Corticosteroids are frequently used in palliative care, but they carry risks such as side effects and the potential for steroid-induced diabetes mellitus (SDM), prompting the need for careful monitoring.
  • A retrospective study aimed to identify how common SDM is in palliative care, evaluate the necessity of glucose screening twice weekly, and find predictors for high-risk patients.
  • Results indicated that SDM occurs more often than previously recognized, with higher doses of dexamethasone linked to increased hyperglycemia risk. Further research is planned to refine guidelines for glucose monitoring considering the comprehensive impact on patient well-being.

Article Abstract

Background: Corticosteroids are one of the most commonly used medications in palliative care. Although the benefit of corticosteroids generally outweighs the risk in the palliative population, side effects are common and necessitate careful consideration prior to prescribing. In March of 2010, a guideline for monitoring blood glucose values was implemented as part of our standard care within our two inpatient tertiary palliative care units.

Method: A retrospective study was conducted, the aim of which was twofold. First, we hoped to determine a prevalence rate for steroid-induced diabetes mellitus (SDM) in palliative care and whether or not screening glucose levels twice weekly was appropriate or required. Second, we wanted to determine if possible predictors existed for the development of SDM in a palliative population, thereby identifying the patients most at risk who would benefit from ongoing glucose monitoring.

Results And Discussion: We found that SDM is more common in palliative care patients than previously thought. Our study showed a higher likelihood of developing hyperglycaemia with higher doses of dexamethasone. But although dose is correlated with hyperglycemia, patients without high doses were also at risk. Further study is currently underway with slight modifications to the guideline to more accurately assess the physical burden, as well as the emotional and financial cost of a hyperglycemia screening protocol.

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Source
http://dx.doi.org/10.1089/jpm.2011.0513DOI Listing

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