Diabetes management during glucocorticoid therapy for nonendocrine disease.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
S S BraithwaiteJ D Thomas

Abstract

To determine current attitudes about management of diabetes during glucocorticoid therapy for nonendocrine disease, as assessed by a pilot survey. A 27-item questionnaire was designed to determine areas of consensus and of disagreement on diabetes management during glucocorticoid therapy for nonendocrine disease and was mailed to 84 Chicago-area academic general internists, endocrinologists, pulmonologists or allergists, rheumatologists, and certified diabetes nurse-educators. The response rate was 55%. For new-onset "steroid diabetes," 43% of respondents agreed with use of insulin and 44% with use of sulfonylurea therapy. Respondents indicated 91 to 95% agreement on the desirability of self-monitoring of blood glucose on initiation of glucocorticoid therapy. For a fasting plasma venous glucose level of 150 mg/dL at the time of initiation of long-term glucocorticoid therapy, 54% of respondents disagreed with immediate increase of insulin in the case of a patient already taking insulin, and 80% disagreed with immediate substitution of insulin in the case of a patient on maximal glyburide therapy (P = 0.0053 for mean change of position). During tapering of glucocorticoid therapy, 75% of respondents approved close observation with...Continue Reading

Citations

Oct 6, 1997·Endocrinology and Metabolism Clinics of North America·I B Hirsch, D S Paauw
Jul 26, 2012·ISRN Endocrinology·Lisa R SimmonsElizabeth L Chua
Sep 1, 1999·Rheumatic Diseases Clinics of North America·B Hoogwerf, R D Danese
Nov 21, 1998·Postgraduate Medicine·S S BraithwaiteS Quddusi
Jul 13, 2012·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Subarna M DhitalDawn Belt Davis

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