Endocrine Abstracts

Glucocorticoids are employed for their immune-suppressive & anti-inflammatory effects in a variety of medical conditions. The metabolic effects pose significant burden including hyperglycaemia in patients without diabetes mellitus & uncontrolled hyperglycaemia in diabetes mellitus (DM). Rates of steroid induced hyperglycaemia (SIH) and Diabetes Mellitus (SIDM) are estimated at 32.3% and 18.6% respectively. The ‘JDBSFIC’ published guidelines in January 2023 titled: Management of Hyperglycaemia and Steroid (glucocorticoid) Therapy. Data of patients being treated with supraphysiological doses of systemic glucocorticoids was gathered retrospectively over 1 week period. Frequency of pre-treatment assessment with HbA1C performed within 3 months prior to treatment and screening for risk factors was collected. Inpatient blood sugar level (BSL) monitoring and escalation as per JDBSFIC guidelines was collected. 10 patients met the criteria for inclusion in the audit. 3 patients had pre-treatment diagnosis of DM. 40% had a HbA1C within 3 months of treatment but no patients with DM had HbA1C checked in the 3 month period. Mean HbA1C was 42.88 mmol/l/l. 2 patients had any BSL checked during admission. Of these patients, 1 had BSL checked at appropriate time to screen for SIH. Both patients had DM. 1 patient with prior history of DM did not have any BSL checked while on systemic corticosteroids. Due to lack of BSL data, we were unable to assess frequency of SIH/SIDM and practices of managing same. The results demonstrates poor compliance with inpatient monitoring of hyperglycaemia with potentially missed diagnosis of SIH & SIDM as well as potential for missed therapeutic intervention.