Kortikosteroidi i šećerna bolest: nove spoznaje i perspektive u liječenju

The mechanism of corticosteroids-induced diabetes mellitus is multifactorial. Corticosteroids induce hepatic and extrahepatic insulin resistance. Corticosteroids have direct harmful effects on insulin-secreting beta cells of the pancreas, decreasing in glucose transport into the beta cells and inducing apoptosis. The risk of corticosteroids-induced diabetes increases with the corticosteroids dosage, duration of therapy, age, family history of diabetes mellitus, obesity, ethnicity and high blood glucose concentrations before corticosteroids therapy. Treatment of patients with corticosteroids-induced hyperglycaemia is diet, exercise and self-monitoring of blood glucose level. Patients with persistent fasting and daytime blood glucose concentrations over 11.1 mmol/L, the treatment with insulin is recommended.