Endocrine Abstracts

JOINT3419

Introduction: Corticosteroids, even when administered topically, are known to induce hyperglycemia or diabetes in predisposed patients. While systemic corticosteroid use is a well-documented cause of diabetes, the risk associated with topical corticosteroids, such as eye drops, is often underestimated. We report a case of diabetes induced by dexamethasone eye drops in a 64-year-old patient admitted for the management of nodular prurigo.

Case Report: A 64-year-old man with no prior history of diabetes was admitted for severe nodular prurigo. Routine laboratory tests revealed elevated fasting blood glucose and HbA1c. The patient had been using dexamethasone eye drops for the past 4 years to treat chronic uveitis. Over the past 2 years, he had gradually developed symptoms of hyperglycemia, including increased thirst, frequent urination, and fatigue. Despite these symptoms, he had not sought medical advice, attributing them to other factors. The patient had no other identifiable risk factors for type 2 diabetes, such as obesity, sedentary lifestyle, or family history.

Discussion: This case highlights the risk of corticosteroid-induced diabetes, even with topical administration. Dexamethasone eye drops, used over an extended period, likely led to systemic absorption, causing insulin resistance and hyperglycemia. The rapid resolution of hyperglycemia following discontinuation of the eye drops supports the diagnosis of medication-induced diabetes. This case also underscores the importance of regular blood glucose monitoring in patients using corticosteroids, particularly in those with prolonged use or additional risk factors.

Conclusion: Topical corticosteroids, including eye drops, can induce diabetes or exacerbate preexisting diabetes due to systemic absorption. Healthcare providers should remain vigilant for this potential complication, especially in patients with long-term use. Regular monitoring of blood glucose and timely intervention can prevent long-term complications.