A case series of steroid-induced diabetes mellitus in Zaria, Nigeria.

Introduction: New-onset diabetes Mellitus can occur in patients without documented hyperglycaemia before corticosteroid therapy, however hyperglycaemia has been reported as an adverse effect of steroids such as Prednisolone.This may be encountered in the management of haematologic disorders or malignancies when prolong administration or high dose prednisolone is used alone or as an adjuvantto cytotoxic agents

Aim: To report three adults who developed hyperglycaemia following an oral administration of prednisolone and to review the current literature on Steroid-induced diabetes mellitus. Method:We undertook a review of the case records of the three patients and an electronic MEDLINE as well as a manual library search of existing pertinent literature.

Result: Three male adults aged 55, 50 and 65 years old developed Diabetes Mellitus following the oral steroid administration. In the first case, oral Prednisolone (60mg/day) was used in combination to a cytotoxic agent Melphalan in the management of a plasma cell dyscrasia (Multiple Myeloma), the second case followed a one week course of same dose of prednisolone for Chronic lymphocytic leukaemia while the third case also had oral prednisolone administered alone for an Autoimmune Haemolytic anaemia. Aging, high body mass index and cumulative doses of steroids may be risk factors for the development of steroid-induced hyperglycaemia. The prevalence of this condition, possible pathogenesis and options for treatment are discussed.

Conclusion: Steroid-induced diabetes mellitus is an important clinical finding that, if recognized early, can be effectively treated. We propose Fasting blood sugar and Oral glucose tolerance test as part of the pretreatment investigation during the evaluation as well as in the course of management of middle aged and elderly patients on steroids.