Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Glucocorticoid-induced diabetes in patients with metastatic spinal cord compression

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Cholecystokinin and the hormone concept

    Research output: Contribution to journalReviewpeer-review

  2. Determining minimal important change for the thyroid-related quality of life questionnaire ThyPRO

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Free testosterone and cardiometabolic parameters in men: comparison of algorithms

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Plasma levels of glucagon but not GLP-1 are elevated in response to inflammation in humans

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. The economic impact of prevention, monitoring and treatment strategies for iodine deficiency disorders in Germany

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: The risk of developing diabetes mellitus (DM) during treatment with high-dose glucocorticoids is unknown and monitoring of glucose is random in many settings.

OBJECTIVE: To determine incidence of and risk factors for induction of DM during high-dose glucocorticoid therapy of metastatic spinal cord compression (MSCC) in patients referred to radiotherapy. Furthermore, to describe the time course of development of DM.

SUBJECTS AND METHODS: 140 patients were recruited (131 were included in the analysis) with MSCC receiving high-dose glucocorticoid ≥100 mg prednisolone per day were included in a prospective, observational cohort study. The primary endpoint was development of DM defined by two or more plasma glucose values ≥11.1 mmol/L. Plasma glucose was monitored on a daily basis for 12 days during radiotherapy.

RESULTS: Fifty-six of the patients (43%; 95% CI 35-52%) were diagnosed with DM based on plasma glucose measurements during the study period. Sixteen patients, 12% (95% CI 6-18%), were treated with insulin. At multivariate analysis, only high baseline HbA1c predicted the development of insulin-treated DM. An HbA1c-value <39 mmol/mol was associated with a negative predictive value of 96% for not developing DM needing treatment with insulin. The diagnosis of diabetes with need for insulin treatment was made within 7 days in 14 of the 16 (88%; 95% CI 72-100%) patients.

CONCLUSION: The risk of developing DM during treatment with high-dose glucocorticoids in patients with MSCC referred to radiotherapy is high in the first treatment week. Only referral HbA1c predicts the development of DM.

Original languageEnglish
JournalEndocrine Connections
Volume7
Issue number5
Pages (from-to)719-726
ISSN2049-3614
DOIs
Publication statusPublished - 2018

ID: 54573582