Corticosteroid induced diabetes in systemic lupus erythematosus patients

Author : Rizna Abdul Cader, Amy Koo Mei Yin, Siti Nurfatin Haron, Azrul Reesha Yassin, Ismail M Ahmad, Rozita Hod

Introduction: Corticosteroid induced diabetes mellitus (DM) is a well-recognized complication in SLE patients receiving corticosteroids with a prevalence of 12.6% to 25.9%. Methods: Cross-sectional study involving SLE patients attending outpatient clinics between February and July 2014 who developed DM after treatment with corticosteroids. Their demographic data, prescription and laboratory investigations were collated and medical records reviewed. Results: 228 patients (207 female, 21 male), aged 40.48 12.86 years with SLE duration of 11.65 6.46 years were recruited. Majority (87%) had lupus nephritis. Their mean BMI was 25.03 5.36 kg/m2. Twenty six (11.4%) patients aged 50.12 11.84 years had corticosteroid induced DM. Their SLE vintage and BMI were 14.38 6.49 years and 22.07 3.24 kg/m2 respectively. All patients received corticosteroid (7.92 4.83 years) prior to development of DM, with a prednisolone dose of 15.00 9.87 mg/day at diagnosis. Their duration of corticosteroid induced DM was 7.31 6.46 years with HbA1c of 7.19 1.95%. We found diabetics to be older, obese and hypertensive. On multivariate analysis, the main risk factors for corticosteroid induced DM were older age and higher BMI. Conclusion: Corticosteroid induced DM is a common complication in SLE patients receiving corticosteroids.

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