Endocrine Abstracts

Steroids are routinely used in the treatment of haematological malignancies, particularly in lymphoid cancers such as lymphoma and myeloma. Steroid-induced hyperglycaemia (SIH) is a recognised complication, yet there are no national or international guidelines on SIH screening in this population. The primary objective of this study was to determine the incidence of Steroid induced hyperglycaemia in patients with haematological malignancies undergoing steroid-based regimens. This was a prospective observational study conducted over a six-month period. Non- diabetic adult patients with newly diagnosed or relapsed haematological malignancies who were due to start steroid-containing chemotherapy regimens were enrolled. During treatment, capillary blood glucose monitoring was performed routinely at each haematology day ward visit. Participants were observed for 6-month following commencement of treatment. Those with two random plasma glucose readings >11.1 mmol/lon separate occasions were referred to the Endocrinology service for assessment. 14 particpants were recruited – 4 participants had prediabetes at screening (HbA1c 39-47mmol/mol). During the follow-up period only 1 patient (7.1%) met the criteria for steroid-induced diabetes. No patients developed clinical symptoms or complications related to hyperglycaemia.The patient who experienced dysglycaemia did not have diabetes risk factors present at recruitment. The incidence rate of new diabetes in patients exposed to steroid containing chemotherapy in this cohort was 7.1%. These findings suggest that routine glucose monitoring in all patients receiving steroid therapy for haematological malignancies may not be necessary. Patients who were pre-diabetic at screening were not seen to develop steroid induced diabetes more frequently than those without pre-diabetes.