Corticosteroid-induced hyperglycemia




Hyperglycemia; Diabetes Mellitus; Adrenal cortex hormones.


Glucocorticoids are medications of wide medical use, notably due to their known anti-inflammatory effects. Furthermore, fluctuations in glycemic indexes stand out as risk factors for clinical and surgical complications, mortality and increased hospital stay. The study consists of an integrative and descriptive literature review, through the PUBMED platform with the following keywords: “Hyperglycemia”, “Glucocorticoid” and “Induce”, in the last 12 years and aims to gather and unify information regarding the understanding and clinical and therapeutic management of hyperglycemia induced by the use of corticosteroids and corticogenic diabetes. The fluctuation in glycemic indexes with the use of corticosteroid therapy is an imbalance between the increase in insulin resistance and the inhibition of insulin production and secretion at the pancreatic cellular level. Screening for Diabetes Mellitus in patients on corticosteroid therapy is based on consensus in the literature with a plasma glucose level above 125 mg/dL, any capillary measurement above 200 mg/dL, HbA1c> 6.5% or oral tolerance test glucose above 200mg/dL after 2 hours. The main glycemic target is capillary blood glucose between 108-180 mg/dL and in cases of initiating therapeutic approaches for hospital management of glycemic fluctuations, the use of insulin therapy is chosen. Hyperglycemia induced by the use of corticosteroids is a topic that has been gaining prominence in the medical scenario, despite the lack of studies that uniformly protocol the approach to patients when this scenario is confirmed, with the aim of reducing the risks associated with hospitalization.


Aberer, F., Hochfellner, D. A., Sourij, H., & Mader, J. K. (2021). A Practical Guide for the Management of Steroid Induced Hyperglycaemia in the Hospital. Journal of Clinical Medicine, 10(10), 2154.

Baldwin, D., & Apel, J. (2012). Management of Hyperglycemia in Hospitalized Patients with Renal Insufficiency or Steroid-Induced Diabetes. Current Diabetes Reports, 13(1), 114–120.

Barker, H. L., Morrison, D., Llano, A., Sainsbury, C. A. R., & Jones, G. C. (2023). Practical Guide to Glucocorticoid Induced Hyperglycaemia and Diabetes. Diabetes Therapy.

Ferrelli, F., Pastore, D., Capuani, B., Lombardo, M. F., Blot-Chabaud, M., Coppola, A., Basello, K., Galli, A., Donadel, G., Romano, M., Caratelli, S., Pacifici, F., Arriga, R., Di Daniele, N., Sbraccia, P., Sconocchia, G., Bellia, A., Tesauro, M., Federici, M., & Della-Morte, D. (2014). Serum glucocorticoid inducible kinase (SGK)-1 protects endothelial cells against oxidative stress and apoptosis induced by hyperglycaemia. Acta Diabetologica, 52(1), 55–64.

Gerards, M. C., Tervaert, E. C. C., Hoekstra, J. B. L., Vriesendorp, T. M., & Gerdes, V. E. A. (2015). Physician’s attitudes towards diagnosing and treating glucocorticoid induced hyperglycaemia: Sliding scale regimen is still widely used despite guidelines. Diabetes Research and Clinical Practice, 109(2), 246–252.

Grommesh, B., Lausch, M. J., Vannelli, A. J., Mullen, D. M., Bergenstal, R. M., Richter, S. A., & Fish, L. H. (2016). Hospital insulin protocol aims for glucose control in glucocorticoid-induced hyperglycemia. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 22(2), 180–189.

Hwang, J. L., & Weiss, R. E. (2014). Steroid-induced diabetes: a clinical and molecular approach to understanding and treatment. Diabetes/Metabolism Research and Reviews, 30(2), 96–102.

Johal, J. S., Cowan, T. L., & Murrell, D. F. (2023). Evaluating the nature and prevalence of glucocorticoid-induced Type 2 diabetes mellitus in patients with autoimmune bullous diseases (AIBDs). Clinical and Experimental Dermatology.

Leiter, A., Carroll, E., Brooks, D., Ben Shimol, J., Eisenberg, E., Wisnivesky, J. P., Galsky, M. D., & Gallagher, E. J. (2021). Characterization of hyperglycemia in patients receiving immune checkpoint inhibitors: Beyond autoimmune insulin-dependent diabetes. Diabetes Research and Clinical Practice, 172, 108633.

Li, P., Hao, Y., Pan, F.-H., Zhang, M., Ma, J.-Q., & Zhu, D.-L. (2016). SGK1 inhibitor reverses hyperglycemia partly through decreasing glucose absorption. Journal of Molecular Endocrinology, 56(4), 301–309.

Litty, A. C., & Chaney, S. (2017). Glucocorticoid-induced hyperglycemia. The Nurse Practitioner, 42(8), 8–11.

Liu, X., Zhu, X., Miao, Q., Ye, H., Zhang, Z., & Li, Y. (2014). Hyperglycemia Induced by Glucocorticoids in Nondiabetic Patients: A Meta-Analysis. Annals of Nutrition and Metabolism, 65(4), 324–332.

Low Wang, C. C., & Draznin, Boris. (2016). Use Of Nph Insulin For Glucocorticoid-Induced Hyperglycemia. Endocrine Practice, 22(2), 271–273.

McDonnell, M., Harris, R. J., Borca, F., Mills, T., Downey, L., Dharmasiri, S., Patel, M., Zare, B., Stammers, M., Smith, T. R., Felwick, R., Cummings, J. R. F., Phan, H. T. T., & Gwiggner, M. (2020). High incidence of glucocorticoid-induced hyperglycaemia in inflammatory bowel disease: metabolic and clinical predictors identified by machine learning. BMJ Open Gastroenterology, 7(1), e000532.

Merkofer, F., Struja, T., Delfs, N., Spagnuolo, C. C., Hafner, J. F., Kupferschmid, K., Baechli, C., Schuetz, P., Mueller, B., & Blum, C. A. (2022). Glucose control after glucocorticoid administration in hospitalized patients – a retrospective analysis. BMC Endocrine Disorders, 22(1).

Nakamura, H., Fujieda, Y., Nakamura, A., & Atsumi, T. (2020). How should rheumatologists manage glucocorticoid-induced hyperglycemia? Modern Rheumatology, 1–10.

Paredes, S., & Alves, M. (2016). Abordagem e Tratamento da Hiperglicemia Induzida por Glicocorticóides. Acta Médica Portuguesa, 29(9), 556.

Perez, A., Jansen-Chaparro, S., Saigi, I., Bernal-Lopez, M. R., Miñambres, I., & Gomez-Huelgas, R. (2014). Glucocorticoid-induced hyperglycemia. Journal of Diabetes, 6(1), 9–20.

Roberts, A., James, J., & Dhatariya, K. (2018). Management of hyperglycaemia and steroid (glucocorticoid) therapy: a guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group. Diabetic Medicine, 35(8), 1011–1017.

Rother, E. T. (2007). Systematic literature review X narrative review. Acta Paulista de Enfermagem, 20(2), v–vi.

Shah, P., Kalra, S., Yadav, Y., Deka, N., Lathia, T., Jacob, J. J., Kota, S. K., Bhattacharya, S., Gadve, S. S., Subramanium, K. a. V., George, J., Iyer, V., Chandratreya, S., Aggrawal, P. K., Singh, S. K., Joshi, A., Selvan, C., Priya, G., Dhingra, A., & Das, S. (2022). Management of Glucocorticoid-Induced Hyperglycemia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 15, 1577–1588.

Snyder, H. (2019). Literature Review as a Research methodology: an Overview and Guidelines. Journal of Business Research, 104(1), 333–339. Science direct.

Uchinuma, H., Ichijo, M., Harima, N., & Tsuchiya, K. (2020). Dulaglutide improves glucocorticoid-induced hyperglycemia in inpatient care and reduces dose and injection frequency of insulin. BMC Endocrine Disorders, 20(1).

van Bommel, E. J. M., de Jongh, R. T., Brands, M., Heijboer, A. C., den Heijer, M., Serlie, M. J., & van Raalte, D. H. (2018). The osteoblast: Linking glucocorticoid-induced osteoporosis and hyperglycaemia? A post-hoc analysis of a randomised clinical trial. Bone, 112, 173–176.

Whyte, M. B., Vas, P. R. J., & Umpleby, A. M. (2021). Could Exogenous Insulin Ameliorate the Metabolic Dysfunction Induced by Glucocorticoids and COVID-19? Frontiers in Endocrinology, 12.




How to Cite

FERREIRA, Y. B. .; JÚCA NETO, J. de R. B. .; DUARTE FILHO, F. B. .; VASCONCELOS, F. A. S. .; MESQUITA, R. O.; CAMPELO, A. P. B. S. .; CAMPELO, M. W. S. . Corticosteroid-induced hyperglycemia. Research, Society and Development, [S. l.], v. 13, n. 1, p. e14813144900, 2024. DOI: 10.33448/rsd-v13i1.44900. Disponível em: Acesso em: 27 may. 2024.



Review Article