Management and Treatment of Glucocorticoid-Induced Hyperglycemia

Detalhes bibliográficos
Autor(a) principal: Paredes, Sílvia
Data de Publicação: 2016
Outros Autores: Alves, Marta
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758
Resumo: Introduction: Glucocorticoids have been associated to several side effects, specially a diabetogenic action, the most common and representative effect. Glucocorticoid-induced hyperglycemia is a common medical condition, with general associated morbidity andmortality.Material and Methods: It was performed a literature review about the management and treatment of glucocorticoid-induced hyperglycemia.Results: Through numerous not quite fully understood mechanics, glucocorticoids promote hyperglycemia in non-diabetic patients andworsen diabetes control in diabetic individuals. Glucocorticoid-induced hyperglycemia presents key patterns, enhanced in the postprandial period and scheduled-dependent. Despite the existence of guidelines for hyperglycemia treatment in non-critic hospitalized and non-hospitalized patients, there are no guidelines respecting glucocorticoid-induced hyperglycemia. Nevertheless, it is known that glucocorticoid-induced hyperglycemia is complex and demanding, requiring a specific approach. Indeed, glucocorticoid-induced hyperglycemia treatment depends on the glucocorticoid used, its dose, frequency and schedule. Furthermore, the scheme of treatment previously used by diabetic individuals also influences the choice of the new scheme.Discussion and Conclusion: The authors reviewed the glucocorticoid induced-hyperglycemia thematic and propose strategies to approach and treat glucocorticoid induced-hyperglycemia in diabetic and non-diabetic individuals. This review is expected to be useful in different settings and crosswise to all medical specialties.
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spelling Management and Treatment of Glucocorticoid-Induced HyperglycemiaAbordagem e Tratamento da Hiperglicemia Induzida por GlicocorticóidesGlucocorticoids/adverse effectsHyperglycemia/chemically inducedHyperglycemia/diagnosisHyperglycemia/therapy.Glucocorticóides/efeitos adversosHiperglicemia/diagnósticoHiperglicemia/induzida quimicamenteHiperglicemia/tratamento.Introduction: Glucocorticoids have been associated to several side effects, specially a diabetogenic action, the most common and representative effect. Glucocorticoid-induced hyperglycemia is a common medical condition, with general associated morbidity andmortality.Material and Methods: It was performed a literature review about the management and treatment of glucocorticoid-induced hyperglycemia.Results: Through numerous not quite fully understood mechanics, glucocorticoids promote hyperglycemia in non-diabetic patients andworsen diabetes control in diabetic individuals. Glucocorticoid-induced hyperglycemia presents key patterns, enhanced in the postprandial period and scheduled-dependent. Despite the existence of guidelines for hyperglycemia treatment in non-critic hospitalized and non-hospitalized patients, there are no guidelines respecting glucocorticoid-induced hyperglycemia. Nevertheless, it is known that glucocorticoid-induced hyperglycemia is complex and demanding, requiring a specific approach. Indeed, glucocorticoid-induced hyperglycemia treatment depends on the glucocorticoid used, its dose, frequency and schedule. Furthermore, the scheme of treatment previously used by diabetic individuals also influences the choice of the new scheme.Discussion and Conclusion: The authors reviewed the glucocorticoid induced-hyperglycemia thematic and propose strategies to approach and treat glucocorticoid induced-hyperglycemia in diabetic and non-diabetic individuals. This review is expected to be useful in different settings and crosswise to all medical specialties.Introdução: Os glicocorticóides associam-se a vários efeitos adversos, entre os quais se destaca uma importante ação diabetogénica. A hiperglicemia induzida pelos glicocorticóides trata-se de uma condição com elevada prevalência e que condiciona importante morbimortalidade.Material e Métodos: Realizou-se uma revisão da literatura relativa à abordagem e tratamento da hiperglicemia induzida pelos glicocorticóidesResultados: Embora não totalmente esclarecidos, sabe-se que vários mecanismos concorrem de forma sinérgica, propiciando o aparecimentoda hiperglicemia em doentes não diabéticos e o agravamento do controlo glicémico em diabéticos. A hiperglicemia induzida por glicocorticóides apresenta padrões característicos, mais marcada no momento pós-prandial e muito dependente do horário da toma do glicocorticóide. Apesar da existência de normas de orientação gerais para o tratamento da hiperglicemia em doentes em ambulatório e em doentes hospitalizados não críticos, o mesmo não acontece no que diz respeito ao tratamento da hiperglicemia induzida por glicocorticóides. E, de facto, frequentemente é difícil e exigente a abordagem deste tipo de hiperglicemia, sendo necessária uma atuação específica. Esta abordagem depende não só do glicocorticóide em causa, como também da sua dose, frequência e horário de administração. De igual forma, a escolha do esquema de tratamento também depende do tipo de terapêutica previamente usado.Discussão e Conclusão: Os autores fizeram uma revisão do tema, congregando e definindo linhas orientadoras para o tratamento dahiperglicemia induzida por glicocorticóides, em doentes diabéticos e não diabéticos, em regime de ambulatório ou internamento, queserão úteis em diferentes contextos e transversalmente às diversas especialidades.Ordem dos Médicos2016-09-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/mswordapplication/mswordapplication/mswordapplication/pdfapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758oai:ojs.www.actamedicaportuguesa.com:article/7758Acta Médica Portuguesa; Vol. 29 No. 9 (2016): September; 556-563Acta Médica Portuguesa; Vol. 29 N.º 9 (2016): Setembro; 556-5631646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/4766https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8433https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8434https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8435https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8489https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8585https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8586https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8587https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8588https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8589https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8590https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8591https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8592https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8593https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7758/8642Direitos de Autor (c) 2016 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessParedes, SílviaAlves, Marta2022-12-20T11:05:19Zoai:ojs.www.actamedicaportuguesa.com:article/7758Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:29.829328Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Management and Treatment of Glucocorticoid-Induced Hyperglycemia
Abordagem e Tratamento da Hiperglicemia Induzida por Glicocorticóides
title Management and Treatment of Glucocorticoid-Induced Hyperglycemia
spellingShingle Management and Treatment of Glucocorticoid-Induced Hyperglycemia
Paredes, Sílvia
Glucocorticoids/adverse effects
Hyperglycemia/chemically induced
Hyperglycemia/diagnosis
Hyperglycemia/therapy.
Glucocorticóides/efeitos adversos
Hiperglicemia/diagnóstico
Hiperglicemia/induzida quimicamente
Hiperglicemia/tratamento.
title_short Management and Treatment of Glucocorticoid-Induced Hyperglycemia
title_full Management and Treatment of Glucocorticoid-Induced Hyperglycemia
title_fullStr Management and Treatment of Glucocorticoid-Induced Hyperglycemia
title_full_unstemmed Management and Treatment of Glucocorticoid-Induced Hyperglycemia
title_sort Management and Treatment of Glucocorticoid-Induced Hyperglycemia
author Paredes, Sílvia
author_facet Paredes, Sílvia
Alves, Marta
author_role author
author2 Alves, Marta
author2_role author
dc.contributor.author.fl_str_mv Paredes, Sílvia
Alves, Marta
dc.subject.por.fl_str_mv Glucocorticoids/adverse effects
Hyperglycemia/chemically induced
Hyperglycemia/diagnosis
Hyperglycemia/therapy.
Glucocorticóides/efeitos adversos
Hiperglicemia/diagnóstico
Hiperglicemia/induzida quimicamente
Hiperglicemia/tratamento.
topic Glucocorticoids/adverse effects
Hyperglycemia/chemically induced
Hyperglycemia/diagnosis
Hyperglycemia/therapy.
Glucocorticóides/efeitos adversos
Hiperglicemia/diagnóstico
Hiperglicemia/induzida quimicamente
Hiperglicemia/tratamento.
description Introduction: Glucocorticoids have been associated to several side effects, specially a diabetogenic action, the most common and representative effect. Glucocorticoid-induced hyperglycemia is a common medical condition, with general associated morbidity andmortality.Material and Methods: It was performed a literature review about the management and treatment of glucocorticoid-induced hyperglycemia.Results: Through numerous not quite fully understood mechanics, glucocorticoids promote hyperglycemia in non-diabetic patients andworsen diabetes control in diabetic individuals. Glucocorticoid-induced hyperglycemia presents key patterns, enhanced in the postprandial period and scheduled-dependent. Despite the existence of guidelines for hyperglycemia treatment in non-critic hospitalized and non-hospitalized patients, there are no guidelines respecting glucocorticoid-induced hyperglycemia. Nevertheless, it is known that glucocorticoid-induced hyperglycemia is complex and demanding, requiring a specific approach. Indeed, glucocorticoid-induced hyperglycemia treatment depends on the glucocorticoid used, its dose, frequency and schedule. Furthermore, the scheme of treatment previously used by diabetic individuals also influences the choice of the new scheme.Discussion and Conclusion: The authors reviewed the glucocorticoid induced-hyperglycemia thematic and propose strategies to approach and treat glucocorticoid induced-hyperglycemia in diabetic and non-diabetic individuals. This review is expected to be useful in different settings and crosswise to all medical specialties.
publishDate 2016
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dc.rights.driver.fl_str_mv Direitos de Autor (c) 2016 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 29 No. 9 (2016): September; 556-563
Acta Médica Portuguesa; Vol. 29 N.º 9 (2016): Setembro; 556-563
1646-0758
0870-399X
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