Introduction

Steroid-induced diabetes (SID) can be defined as the occurrence of hyperglycemic state in non-diabetic individuals following steroid therapy. The traditional risk factors for type 2 DM, such as age, abdominal obesity, family history, and physical activity, have been incorporated in the Indian diabetes risk score (IDRS). We conducted this study to determine the use of IDRS in the prediction of SID.

Materials and methods

A prospective observational, cohort study on non-diabetic subjects, aged between 18 and 70 years, on oral or parenteral steroid therapy for different diseases was conducted. Anthropometric records were collected. Baseline biochemical parameters in the blood (FPG, PPG, and HbA1c) were measured before initiating steroid therapy. The biochemical parameters, except HbA1c, were measured again on day 3 after steroid therapy initiation. Based on FPG and PPG of day 3, participants were categorized as normal, pre-diabetic, and diabetic. Based on IDRS, patients with SID were categorized as low-risk, moderate-risk, and high-risk IDRS groups for further analysis.

Results

Out of 317 subjects, SID was found in 132(42%) subjects. We observed significantly higher age (p value = 0.04) and BMI (p value = 0.03) in diabetes group compared to normal and pre-diabetes groups. There was no significant difference (p = 0.6) in mean waist circumference across steroid-induced diabetic groups. A sedentary lifestyle (p = 0.359) and family history (p value = 0.388) have no association with SID. The incidence of SID was significantly high among high-risk IDRS (58%) when compared to that of low-risk (34.8%) and medium-risk (36%) IDRS (p < 0.001). IDRS more than 60 showed odds ratio of 1.69 (95% C.I, 1.24–2.16, p < 0.001) for steroid-induced diabetes. IDRS of more than 30 had 71.4% sensitivity and 44.6% specificity for SID (p value = 0.001).

Conclusions

The cumulative scores of IDRS were higher in patients with SID. This score may be used as an initial screening test to select patients for blood sugar monitoring in those treated with steroids on OPD basis.

中文翻译：

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印度糖尿病风险评分 (IDRS) 在类固醇诱发的糖尿病中的应用

简介

类固醇诱导的糖尿病 (SID) 可以定义为非糖尿病个体在类固醇治疗后出现高血糖状态。2 型糖尿病的传统危险因素，如年龄、腹部肥胖、家族史和体力活动，已被纳入印度糖尿病风险评分 (IDRS)。我们进行了这项研究以确定 IDRS 在 SID 预测中的使用。

材料和方法

对年龄在 18 至 70 岁之间的非糖尿病受试者进行了一项前瞻性观察性队列研究，他们针对不同疾病进行口服或肠胃外类固醇治疗。收集了人体测量记录。在开始类固醇治疗之前测量血液中的基线生化参数（FPG、PPG 和 HbA1c）。在类固醇治疗开始后第 3 天再次测量除 HbA1c 之外的生化参数。根据第 3 天的 FPG 和 PPG，参与者被分为正常、糖尿病前期和糖尿病。根据IDRS，将SID患者分为低危、中危和高危IDRS组，以供进一步分析。

结果

在 317 名受试者中，132 名 (42%) 受试者发现了 SID。我们观察到糖尿病组的年龄（p值 = 0.04）和 BMI（p值 = 0.03）显着高于正常和糖尿病前期组。类固醇诱导的糖尿病组的平均腰围没有显着差异（p = 0.6）。久坐的生活方式 (p = 0.359) 和家族史 ( p值 = 0.388) 与 SID 无关。与低风险 (34.8%) 和中风险 (36%) IDRS 相比，高风险 IDRS (58%) 的 SID 发生率显着较高 (p < 0.001)。超过 60 的 IDRS 显示类固醇诱导的糖尿病的优势比为 1.69（95% CI，1.24-2.16，p < 0.001）。超过 30 的 IDRS 对 SID 的敏感性为 71.4%，特异性为 44.6%（p 值 = 0.001）。

结论

SID 患者的 IDRS 累积评分较高。该评分可用作初始筛选测试，以在 OPD 基础上选择接受类固醇治疗的患者进行血糖监测。