Related Experiment Video
Updated: May 22, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Corticosteroid-induced diabetes in palliative care
Jana Pilkey1, Lisa Streeter, Alexandra Beel
1Program of Palliative Care, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada. JPILKEY@wrha.mb.ca
Journal of Palliative Medicine
|May 16, 2012
Summary
Steroid-induced diabetes mellitus (SDM) is more prevalent in palliative care than previously recognized. Higher dexamethasone doses increase hyperglycemia risk, but patients on lower doses are also susceptible, warranting careful monitoring.
Area of Science:
- Palliative Care Medicine
- Endocrinology
- Pharmacology
Background:
- Corticosteroids are frequently prescribed in palliative care.
- While beneficial, corticosteroid side effects require careful management.
- A guideline for blood glucose monitoring was implemented in 2010.
Purpose of the Study:
- Determine the prevalence of steroid-induced diabetes mellitus (SDM) in palliative care.
- Assess the appropriateness of twice-weekly glucose screening.
- Identify predictors for SDM development in this population.
Main Methods:
- Retrospective study design.
- Analysis of palliative care patient data.
- Evaluation of glucose monitoring guideline effectiveness.
Main Results:
- SDM is more common in palliative care patients than previously assumed.
- Higher dexamethasone doses correlate with increased hyperglycemia risk.
- Patients on lower dexamethasone doses also remain at risk for hyperglycemia.
Conclusions:
- Current screening protocols may need adjustment.
- Further research is needed to optimize hyperglycemia screening in palliative care.
- The physical, emotional, and financial burden of screening requires further assessment.
Related Concept Videos
01:19Type I Diabetes III: Clinical Manifestations
Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
01:22Complications of Diabetes Mellitus
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
01:15Diabetes: Management and Pharmacotherapy
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
01:26Type I Diabetes II: Pathophysiology
Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
01:26Diabetes Mellitus: Introduction
Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...
01:12Type I Diabetes I: Introduction
Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1 diabetes is an...