Endocrine Abstracts

JOINT671

Introduction: Corticosteroid therapy, widely used in hospital settings for its anti-inflammatory and immunosuppressive effects, is known for its hyperglycemic effects. Despite its frequent use, its impact on glycemic control in hospitalized diabetic patients remains underexplored. This study aims to evaluate the influence of corticosteroid therapy on glycemic control in hospitalized diabetic patients.

Patients and methods: We conducted a multicenter, cross-sectional study over three months in three Tunisian university hospitals: Hedi Chaker University Hospital in Sfax, Habib Bourguiba University Hospital in Sfax, and Taher Sfar University Hospital in Mahdia. The study included diabetic patients hospitalized in medical and surgical departments. Data collected included corticosteroid prescription during hospitalization, the dose of corticosteroid prescribed in prednisone-equivalent milligrams, the occurrence of acute hyperglycemic complication or hypoglycemia, and glycemic control evaluation. Glycemic control was classified as insufficient if less than 50% of capillary blood glucose (CBG) readings were below the in-hospital glycemic target (defined by the ADA as 1–1.8 g/l), moderate if 50–70% of CBG readings were within the target, and satisfactory if more than 70% of CBG readings met the target.

Results: The total number of patients included was 315, of whom 65% were men. Twenty-seven patients (8.5%) received corticosteroid therapy during their hospitalization. The median corticosteroid dose administered was 53 mg [50–75] of prednisone equivalent per day. Diabetes was newly diagnosed in three patients during corticosteroid therapy. Among patients treated with corticosteroids, glycemic monitoring was not performed in three cases, while four patients experienced acute hyperglycemic decompensation, one patient developed hypoglycemia, and 14 patients (51.9%) had poor glycemic control during hospitalization. Insulin therapy was used to manage hyperglycemia in 80% of corticosteroid-treated patients (n = 21), with sliding scale insulin being the most commonly prescribed regimen (16 patients, 59.3%). Corticosteroid therapy was not significantly associated with acute hyperglycemic decompensation (P = 0.416) or poor glycemic control (P = 0.435). However, corticosteroid therapy was associated with a significantly lower risk of hypoglycemia (P = 0.027).

Conclusion: This study demonstrates that corticosteroid therapy in hospitalized settings did not significantly influence the risk of acute hyperglycemic decompensation or overall glycemic control in diabetic patients. However, its use was associated with a significantly reduced risk of hypoglycemia.