Acute Hyperglycemia Due to Topical Corticosteroid Administration
1VA Greater Los Angeles Healthcare System and Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, UCLA David Geffen School of Medicine, 900 Veteran Avenue, 24-130 Warren Hall, Los Angeles, CA 90095, USA.
Topical corticosteroids can cause significant hyperglycemia in patients with type 1 diabetes, even with short-term use. This case highlights the need for careful monitoring of blood glucose levels when using potent steroids.
Area of Science:
- Endocrinology
- Dermatology
Background:
- Type 1 diabetes management requires careful insulin titration.
- Topical corticosteroids are frequently used for dermatological conditions.
Observation:
- A 71-year-old male with type 1 diabetes experienced acute hyperglycemia.
- His insulin needs increased fivefold after applying a potent topical corticosteroid for psoriasis.
Findings:
- Hyperglycemia resolved upon discontinuation of the topical corticosteroid.
- The patient's insulin requirements returned to baseline with his insulin pump.
Implications:
- Potent topical corticosteroids can induce significant hyperglycemia in diabetic patients.
- Clinicians should consider steroid-induced hyperglycemia in diabetic patients with unexplained glycemic control issues.
- Monitoring blood glucose is crucial during topical corticosteroid therapy in patients with diabetes.
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