J Endocrinol Metab
Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website http://www.jofem.org


Volume 8, Number 2-3, May 2018, pages 15-15

The Efficacious and Safe Treatment for Steroid-Induced Hyperglycemia

Hidekatsu Yanai

Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan

Manuscript submitted February 19, 2018Manuscript submitted February 28, 2018Short title: Editorial
doi: https://doi.org/10.14740/jem492w

In Vol. 8, No. 1, 2018, p10-12, Hamasaki and Morimitsu report an efficacious and safe application of glucagon-like peptide-1 (GLP-1) analogue to steroid-induced hyperglycemia in an old type 2 diabetic patient with renal insufficiency [1]. Glucocorticoid-induced insulin resistance and pancreatic islet-cell dysfunction lead to mild increase in fasting plasma glucose levels and a greater increase in postprandial glucose levels [2-7]. The underlying mechanisms for glucocorticoid-induced hyperglycemia include increased hepatic endogenous glucose production, reduced insulin-stimulated glucose uptake in skeletal muscle, and increased visceral fat deposition and insulin resistance [2, 3, 8]. Moreover, glucocorticoids may impair insulin secretion from β cells and may augment glucagon secretion from α cells [2, 4, 5]. Although there are no guidelines for the treatment of hyperglycemia in patients taking glucocorticoids, short-acting prandial insulin therapy is currently recommended [9]. However, insulin therapy increases the risk of adverse effects, such as hypoglycemia and weight gain. Furthermore, it is too difficult to determine the optimal insulin dose, because the doses and efficacy of glucocorticoids are frequently changed due to the severity of the diseases treated by glucocorticoids.

We previously reported the effectiveness and safety of sitagliptin, one of the dipeptidyl peptidase-4 (DPP-4) inhibitors, for the treatment of hyperglycemia in patients taking glucocorticoids [10, 11]. Jensen et al reported that glucocorticoid-induced glucose intolerance is associated with a progressive decline of incretin effects [12], suggesting the incretin-based therapy including the DPP-4 inhibitors and GLP-1 analogues may be useful for the treatment of glucocorticoid-induced hyperglycemia.

Conflict of Interest

The author declares that he has no conflict of interest concerning this article.

  1. Hamasaki H, Morimitsu S. Steroid-induced hyperglycemia successfully treated with once-weekly dulaglutide in an old patient with type 2 diabetes. J Endocrinol Metab. 2018;8(1):10-12.
  2. van Raalte DH, Diamant M. Steroid diabetes: from mechanism to treatment? Neth J Med. 2014;72(2):62-72.
  3. Rockall AG, Sohaib SA, Evans D, Kaltsas G, Isidori AM, Monson JP, Besser GM, et al. Computed tomography assessment of fat distribution in male and female patients with Cushing's syndrome. Eur J Endocrinol. 2003;149(6):561-567.
    doi pubmed
  4. van Raalte DH, Brands M, van der Zijl NJ, Muskiet MH, Pouwels PJ, Ackermans MT, Sauerwein HP, et al. Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial. Diabetologia. 2011;54(8):2103-2112.
    doi pubmed
  5. Wise JK, Hendler R, Felig P. Influence of glucocorticoids on glucagon secretion and plasma amino acid concentrations in man. J Clin Invest. 1973;52(11):2774-2782.
    doi pubmed
  6. Iwamoto T, Kagawa Y, Naito Y, Kuzuhara S, Kojima M. Steroid-induced diabetes mellitus and related risk factors in patients with neurologic diseases. Pharmacotherapy. 2004;24(4):508-514.
    doi pubmed
  7. Burt MG, Roberts GW, Aguilar-Loza NR, Frith P, Stranks SN. Continuous monitoring of circadian glycemic patterns in patients receiving prednisolone for COPD. J Clin Endocrinol Metab. 2011;96(6):1789-1796.
    doi pubmed
  8. Rizza RA, Mandarino LJ, Gerich JE. Cortisol-induced insulin resistance in man: impaired suppression of glucose production and stimulation of glucose utilization due to a postreceptor detect of insulin action. J Clin Endocrinol Metab. 1982;54(1):131-138.
    doi pubmed
  9. Clore JN, Thurby-Hay L. Glucocorticoid-induced hyperglycemia. Endocr Pract. 2009;15(5):469-474.
    doi pubmed
  10. Katsuyama H, Sako A, Adachi H, Hamasaki H, Yanai H. Effects of 6-month sitagliptin treatment on metabolic parameters in diabetic patients taking oral glucocorticoids: a retrospective cohort study. J Clin Med Res. 2015;7(6):479-484.
    doi pubmed
  11. Yanai H, Masui Y, Yoshikawa R, Kunimatsu J, Kaneko H. Dipeptidyl peptidase-4 inhibitor for steroid-induced diabetes. World J Diabetes. 2010;1(3):99-100.
    doi pubmed
  12. Jensen DH, Aaboe K, Henriksen JE, Volund A, Holst JJ, Madsbad S, Krarup T. Steroid-induced insulin resistance and impaired glucose tolerance are both associated with a progressive decline of incretin effect in first-degree relatives of patients with type 2 diabetes. Diabetologia. 2012;55(5):1406-1416.
    doi pubmed

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Journal of Endocrinology and Metabolism is published by Elmer Press Inc.


Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.jofem.org   editorial contact: editor@jofem.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.