Steroid-induced diabetes in the paediatric population

Pediatric endocrinology, diabetes, and metabolism
Marcelina DrucisMałgorzata Myśliwiec

Abstract

Steroid-induced diabetes is a rare disease in the paediatric population. High doses of corticosteroids are used in diseases such as acute lymphoblastic leukaemia (ALL), lymphomas, or connective tissue diseases. Post-steroid hyperglycaemia arises as a result of increased gluconeogenesis and increased glycogen synthesis. Steroid-induced diabetes most often is asymptomatic; therefore it is important to monitor the glycaemic level in patients receiving systemic glucocorticoids. So far, no separate guidelines for steroid-induced diabetes have been developed, so the criteria for diagnosing drug-related diabetes mellitus do not differ from the criteria for diagnosing type 2 diabetes. Hyperglycaemia adversely affects the immune system: it impairs the function of granulocytes, immunoglobulins, and also causes T-lymphocyte apoptosis. A hyperglycaemic environment favours the development of bacterial and fungal infections. Numerous studies confirm that hyperglycaemia increases the risk of infection and severity of infection. There have also been reports of adverse effects of steroid-induced hyperglycaemia in the course of treatment for the underlying disease in the adult population. Reports related to the paediatric population are not as n...Continue Reading

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