Endocrine Abstracts

JOINT2706

Backround: Glucocorticoids (GC) are still the first-line treatment of many autoimmune, inflammatory and allergic conditions. The prevalence of glucocorticoid induced hyperglycemia is not well known in the paediatric population. Specific recommendations for timing and frequency of blood glucose monitoring are lacking in children receiving high doses of glucocorticoids.

Objective: To describe the blood sugar profiles measured with continuous glucose monitoring (CGM) in children receiving systemic glucocorticoid treatment.

Methods: Children who received glucocorticoid treatment due to an underlying condition at a dose of at least 1 mg/kg/day prednisolone-equivalent were monitored with a iPro 2 or a Guardian 4 continuos glucose monitor during their GC treatment course. CGM data and blood sugar profiles were analyzed retrospectively. Time above range and time in range (TAR - percentage of glucose values above 10 mmol/l, TIR - precentage of glucose values in the range 3.9- 10 mmol/l) were measured and diurnal glucose variations were analyzed.

Results: Blood sugar profiles were measured in 10 patients (2 boys, 8 girls) aged 4 to 17 years (mean age 10,5 years ± 0.7 years) over the mean period of 5 days. Six patients received oral prednisolone and 4 received intravenous methylprednisolone. Seven patients experienced episodes of hyperglycemia. The average TIR of the partcipants during the GC treartment was 93.0 ± 36.9%, the average recorded TAR was 6.1 ± 9.1%. The average sensor glucose (SG) at 08:00 AM was 5.0 ± 1.6 mmol/l, at 08:00 PM 8.3 ± 3.0 mmol/l and at midnight 7.6 ± 2.6 mmol/l. Hyperglycemic episodes occured predomonitatly between 18:00-21:00PM and presented mainly as a single prolonged postprandial episode after dinner or late evening snack.

Discussion and conclusion: Two thirds of the investigated subjects experienced GC-induced hyperglycemia. Participants experienced episodes of hyperglycemia regardless of the route of GC administration. Higher SG measurements were registered during evening hours compared to early morning and this should be taken into account, when screening for GC-induced hyperglycemia.