Quick reference
Quickest reference from my local GGC (Glasgow) medicines handbook
- GGC - Steroid-induced diabetes / hyperglycaemia - Landing page
- Management of steroid induced diabetes flowchart
- Management of steroid induced hyperglycaemia flowchart
The most comprehensive guideline is the JBDS-IP (Joint British Diabetes Societies for inpatient care) - Management of Hyperglycaemia and Steroid Glucocorticoid Therapy
Direct link to pages
Page 9 - Table 1 - assessment of hyperglycaemia in people taking steroids
Page 10 - Treatment Algorithm
Page 16 - Treatment of steroid induced hyperglycaemia in people who have type 1 or type 2 diabetes
In brief - from JBDS-IP
- If no diabetes and CBG >12 on 2 occasions - start treatment as per algorithm
- If known diabetes - target CBG 6 - 10 (acceptable range 6-12) - use flowchart to adjust medications or seek advice
- EOLC - Aim CBG 6-15mmol and symptom relief. If on Insulin should have specialist diabetic team input
- If steroids reduced or discontinued - doses likely to be needed to reduce in tandem. “e.g., a weekly 5mg reduction of prednisolone from 20mg may require a 20-25% reduction in insulin dose, or a 40mg reduction in gliclazide” - see page 17
- Follow up should be arranged - similar to gestational diabetes - repeat HbA1c 3 months after steroid cessation and then HbA1c should be repeated yearly.
Patient information leaflet
Patient information leaflet for Type 2 diabetes and steroids from Trend diabetes