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The Effects of Mitiglinide and Repaglinide on Postprandial Hyperglycemia in Patients Undergoing Methylprednisolone

Kenichi Tanaka1, Yosuke Okada1, Hiroko Mori1

  • 1First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Japan.

Internal Medicine (Tokyo, Japan)
|October 13, 2017
PubMed

Insights

Methylprednisolone (MP) pulse therapy can cause high blood sugar. Repaglinide was more effective than mitiglinide in managing steroid-induced diabetes in patients with thyroid ophthalmopathy.

Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Methylprednisolone (MP) pulse therapy is associated with acute dose-dependent hyperglycemia.
  • Thyroid ophthalmopathy patients with normal glucose tolerance may be susceptible to steroid-induced hyperglycemia.

Observation:

  • Five patients with thyroid ophthalmopathy underwent continuous glucose monitoring during MP pulse therapy.
  • MP therapy led to increased mean sensor glucose levels and steroid-induced diabetes in all patients.

Findings:

  • Repaglinide (1.5 mg/day) demonstrated more favorable sensor glucose levels before meals compared to mitiglinide (30 mg/day).
  • Both medications were administered during the second or third MP pulse therapy cycles.

Implications:

  • Repaglinide may be a more clinically appropriate treatment for managing steroid-induced hyperglycemia in this patient population.
  • This study highlights the importance of glucose monitoring during MP pulse therapy for patients with thyroid ophthalmopathy.
Keywords:
continuous glucose monitoringmethylprednisolone pulse therapymitigliniderapid-acting insulin secretagoguerepaglinidesteroid-induced diabetes

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