Minireviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 25, 2015; 6(8): 1073-1081
Published online Jul 25, 2015. doi: 10.4239/wjd.v6.i8.1073
Steroid hyperglycemia: Prevalence, early detection and therapeutic recommendations: A narrative review
Héctor Eloy Tamez-Pérez, Dania Lizet Quintanilla-Flores, René Rodríguez-Gutiérrez, José Gerardo González-González, Alejandra Lorena Tamez-Peña
Héctor Eloy Tamez-Pérez, Dania Lizet Quintanilla-Flores, Alejandra Lorena Tamez-Peña, Internal Medicine Service, “Dr. José Eleuterio González” University Hospital and School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
Héctor Eloy Tamez-Pérez, José Gerardo González-González, Research Division, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
René Rodríguez-Gutiérrez, José Gerardo González-González, Endocrinology Service, “Dr. José Eleuterio González” University Hospital and School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
Author contributions: Tamez-Pérez HE designed the study, writing and editing of the manuscript; Quintanilla-Flores DL, Rodríguez-Gutiérrez R, González-González JG and Tamez-Peña AL contributed to data collection.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Open-Access: This article is an open-access article which was selected byan in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Héctor Eloy Tamez-Pérez, MD, Research Division, School of Medicine, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo León 64460, México. hectoreloytp@gmail.com
Telephone: +52-81-83294050 Fax: +52-81-83294050
Received: November 21, 2014
Peer-review started: November 23, 2014
First decision: January 8, 2015
Revised: May 28, 2015
Accepted: June 18, 2015
Article in press: June 19, 2015
Published online: July 25, 2015
Processing time: 256 Days and 7 Hours
Abstract

Steroids are drugs that have been used extensively in a variety of conditions. Although widely prescribed for their anti-inflammatory and immunosuppressive properties, glucocorticoids have several side effects, being hyperglycemia one of the most common and representative. In the present review, we discuss the main epidemiologic characteristics associated with steroid use, with emphasis on the identification of high risk populations. Additionally we present the pathophysiology of corticosteroid induced hyperglycemia as well as the pharmacokinetics and pharmacodynamics associated with steroid use. We propose a treatment strategy based on previous reports and the understanding of the mechanism of action of both, the different types of glucocorticoids and the treatment options, in both the ambulatory and the hospital setting. Finally, we present some of the recent scientific advances as well as some options for future use of glucocorticoids.

Keywords: Steroid; Hyperglycemia; Diabetes mellitus; Treatment; Insulin

Core tip: Steroids are drugs that have been used extensively in a variety of conditions. Although widely prescribed for their anti-inflammatory and immunosuppressive properties, glucocorticoids have several side effects, being hyperglycemia one of the most common and representative. We present the pathophysiology of corticosteroid induced hyperglycemia as well as the pharmacokinetics and pharmacodynamics associated with steroid use.