Skip to main content

Advertisement

Log in

Utilization of Indian diabetes risk score (IDRS) in steroid-induced diabetes

  • Original article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ingle DJ. The production of glycosuria in the normal rat by means of 17-hydroxy-11-dehydrocorticosterone. Endocrinology. 1941;29:649–52.

    Article  CAS  Google Scholar 

  2. Di Dalmazi G, Pagotto U, Pasquali R, Vicennati V. Glucocorticoids and type 2 diabetes: from physiology to pathology. J Nutr Metab. 2012;2012:1–9.

    Article  Google Scholar 

  3. Simmons LR, Molyneaux L, Yue DK, Chua E. Steroid-induced diabetes: is it just unmasking of type 2 diabetes? ISRN Endocrinol. 2012;2012:1–5.

    Article  Google Scholar 

  4. Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian diabetes risk score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005;53:759–63.

    CAS  PubMed  Google Scholar 

  5. American Diabetes Association. Standards of medical care in diabetes—2015 abridged for primary care providers. Clin Diabetes. 2015;33(2):97–111.

    Article  Google Scholar 

  6. Misra A. Ethnic-specific criteria for classification of body mass index: a perspective for Asian Indians and American Diabetes Association position statement. Diabetes Technol Ther. 2015;17(9):667–71.

    Article  Google Scholar 

  7. Quetelet EGA. The average man and indices of obesity. Nephrol Dial Transpl. 2008;23(1):47–51.

    Google Scholar 

  8. Waist circumference and waist-hip ratio: report of a WHO expert consultation [Internet]. Who.int. [cited 2021 Jun 1]. Available from: https://www.who.int/publications-detail-redirect/9789241501491.

  9. Analysis Guide. Global physical activity questionnaire [Internet]. Who.int. [cited 2021 Jul 2]. Available from: https://www.who.int/ncds/surveillance/steps/resources/GPAQ_Analysis_Guide.pdf.

  10. Anbalagan VP, Venkataraman V, Vamsi M, Deepa M, Mohan V. A simple Indian diabetes risk score could help identify nondiabetic individuals at high risk of non-alcoholic fatty liver disease (CURES-117). J Diabetes Sci Technol. 2012;6(6):1429–35.

    Article  Google Scholar 

  11. Mohan V, Sandeep S, Deepa M, Gokulakrishnan K, Datta M, Deepa R. A diabetes risk score helps identify metabolic syndrome and cardiovascular risk in Indians–the Chennai urban rural epidemiology study (CURES-38). Diabetes Obes Metab. 2007;9(3):337–43.

    Article  CAS  Google Scholar 

  12. Sharma KM, Ranjani H, Nguyen H, Shetty S, Datta M, Narayan KV, et al. Indian diabetes risk score helps to distinguish type 2 from non-type 2 diabetes mellitus (GDRC-3). J Diabetes Sci Technol. 2011;5(2):419–25.

    Article  Google Scholar 

  13. Adhikari P, Pathak R, Kotian S. Validation of the mdrf-Indian diabetes risk score (idrs) in another south Indian population through the Boloor diabetes study (bds). J Assoc Physicians India. 2010;58(434):6.

    Google Scholar 

  14. Nagarathna R, Tyagi R, Battu P, Singh A, Anand A, Nagendra HR. Assessment of risk of diabetes by using Indian diabetic risk score (IDRS) in Indian population. Diabetes Res Clin Pract. 2020;162:108088.

    Article  Google Scholar 

  15. Rao NK, Patil N, Vidyasagar S, Rau NR, Holla AM, Avinash A. Clinical and biochemical profile of steroid-induced diabetes. Asian J Pharm Clin Res. 2016;9(2):262–6.

    Google Scholar 

  16. Shanbhogue VV, Vidyasagar S, Madken M, Varma M, Prashant CK, Seth P, et al. Indian diabetic risk score and its utility in steroid induced diabetes. J Assoc Physicians India. 2010;58(3):201–2.

    Google Scholar 

  17. Katsuyama T, Sada K-E, Namba S, Watanabe H, Katsuyama E, Yamanari T, et al. Risk factors for the development of glucocorticoid-induced diabetes mellitus. Diabetes Res Clin Pract. 2015;108(2):273–9.

    Article  CAS  Google Scholar 

  18. Kim SY, Yoo C-G, Lee CT, Chung HS, Kim YW, Han SK, et al. Incidence and risk factors of steroid-induced diabetes in patients with respiratory disease. J Korean Med Sci. 2011;26(2):264–7.

    Article  Google Scholar 

  19. Elahi D, Muller DC, Egan JM, Andres R, Veldhuis J, Meneilly GS. Glucose tolerance, glucose utilization and insulin secretion in ageing. In: Novartis Foundation Symposium. Wiley Online Library; 2002. p. 222–46.

  20. Raúl CA-A, Barile-Fabris LA, Frati-Munari AC, Baltazár-Montufar P. Risk factors for steroid diabetes in rheumatic patients. Arch Med Res. 1998;29(3):259–62.

    Google Scholar 

  21. Iwamoto T, Kagawa Y, Naito Y, Kuzuhara S, Kojima M. Steroid-induced diabetes mellitus and related risk factors in patients with neurologic diseases. Pharmacother J Hum Pharmacol Drug Ther. 2004;24(4):508–14.

    Article  Google Scholar 

Download references

Funding

This study was financially supported by the Research Society for the Study of Diabetes in India (RSSDI) grants.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sudha Vidyasagar.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bolanthakodi, N., Holla, A., Vidyasagar, S. et al. Utilization of Indian diabetes risk score (IDRS) in steroid-induced diabetes. Int J Diabetes Dev Ctries 42, 254–260 (2022). https://doi.org/10.1007/s13410-021-00976-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-021-00976-y

Keywords

Navigation