ABSTRACT

Objective: The objectives of this study were to determine the frequency of impaired blood glucose in non-diabetic patients on steroid pulse therapy and to compare the frequency of various attributing factors in patients with impaired blood glucose in non-diabetic patients on steroid pulse therapy.

Design: It was a cross-sectional study.

Study Settings: The study was at conducted at Department of Medicine Shalamar Hospital, Lahore over a period of 6 months from 09-01-2020 to 08-07-2020.

Material and Methods: Total 371 non-diabetic patients from both the genders were involved in this study, they had ages between 18-70 years, receiving steroid pulse therapy for rheumatoid arthritis or systemic lupus erythematosus. Blood glucose level was estimated after 2 hours of steroid pulse therapy and a rise of ≥20mg/dl blood sugar level from the baseline was labeled as impaired blood glucose. A written informed consent was obtained from every patient.

Results: The mean age of the patients was 43.75±14.33 years. There were 159 (42.9%) male and 212 (57.1%) female patients. Mean BMI of the patients was 27.34±3.72 Kg/m2. Number of hypertensive patients was 81 (21.8%) while 42 (11.3%) patients had positive family history of diabetes. Impaired blood glucose was observed in 204 (55.0%) patients after steroid pulse therapy. The frequency of female gender (69.1% vs. 42.5%; p-value<0.001), hypertension (26.5% vs. 16.2%; p-value=0.017) and positive family history (16.2% vs. 5.4%; p-value=0.001) was significantly higher in patients with impaired blood glucose after steroid pulse therapy.

Conclusion: A substantial proportion of non-diabetic patients receiving steroid pulse therapy had impaired blood glucose and female gender, hypertension and positive family history of diabetes were found attributable to this steroid induced hyperglycemic state which advocates routine monitoring of blood sugar level among patients receiving steroid pulse therapy, particularly females, hypertensive and patients with positive family history so that patient outcome may be improved by timely identification and management.

Keywords: Steroid Pulse Therapy, Impaired Blood Glucose, Attributing Factors