Short Steroid Treatment May Raise Diabetes Risk: Study

People who received systemic glucocorticoids during short hospital stays were more than twice as likely to develop new onset diabetes than those who didn’t, reported the authors of a large study that analyzed more than a decade’s worth of patient records.

Rajna Golubic, MD, PhD, of the diabetes trials unit at the University of Oxford, Oxford, United Kingdom, and colleagues did an observational cohort study, using data from electronic healthcare records of more than patients admitted between January 1, 2013, and October 1, 2023.

They looked for patients who didn’t have a diabetes diagnosis at the time of admission and who were not taking a steroid. Their research was presented this month at the European Association for the Study of Diabetes (EASD) in Madrid, Spain.

About 1.8%, of 316, of the 17,258 patients who received systemic glucocorticoids (tablets, injections or infusions) during their hospital stay developed new-onset diabetes, while this happened to only 0.8%, or 3450, of the 434,348 who did not get these drugs, according to an abstract of the EASD presentation.

The median length of stay was 3 days (2-8) for the group of patients who took steroids, compared with 1 day (1-3) in those who did not. Further analysis showed that, when age and sex were factored in, patients receiving systemic glucocorticoids were more than twice as likely (2.6 times) to develop diabetes as those not receiving the treatment, Golubic said.

This research builds on previous studies that looked at smaller groups of patients and the diabetes risk for patients with specific conditions, including rheumatoid arthritis, Golubic said. It may prove helpful for clinicians considering when to employ steroids, which are useful medications for managing inflammation associated with many conditions.

“This gives them a very good estimate of how much more likely people treated with systemic glucocorticoids are to develop new-onset diabetes,” Golubic said.

Glucocorticoids have for decades been used for managing acute and chronic inflammatory diseases. The link to diabetes has been previously reported in smaller studies and in ones linked to specific conditions such as respiratory disease and rheumatoid arthritis.

Carolyn Cummins, PhD, an associate professor at the University of Toronto, Canada, who was not part of this study, told Medscape Medical News she was pleased to see a study of diabetes and steroids done with the scope that Golubic and colleagues undertook. Cummins in 2022 published an article in Nature Reviews Endocrinology, “Fresh insights into glucocorticoid-induced diabetes mellitus and new therapeutic directions.”

“We know that this is an issue, but we didn’t necessarily know numerically how significant it was,” Cummins said. “I would say it wasn’t a surprising finding, but it’s nice to actually have the numbers from a large study.”

Golubic and Cummins reported no relevant financial relationships.

Kerry Dooley Young is a freelance journalist based in Washington, DC.