Topical corticosteroids and risk of diabetes mellitus: systematic review and meta-analysis

Topical steroids have been previously associated with potential for hyperglycemia and glucosuria, and thought to have a relatively safe side effect profile. In prolonged use, there is the potential for steroids to be absorbed through the skin and eventually reach systemic circulation. We aimed to investigate the potential association between topical corticosteroid use and development of diabetes, we performed a systematic review and meta-analysis of available case-control data in the literature.

Electronic database searches was performed to identify studies comparing the proportion of patients with diabetes in cases using topical corticosteroids compared to those without. The odds ratio (OR) was used as a summary statistic.

Four case-control studies were pooled for meta-analysis. Overall, we found a significant association between topical corticosteroid use and development of type 2 diabetes mellitus, even after adjustment for confounding factors (OR 1.24, 95% CI 1.15-1.34, I2 = 91%, p < .00001). There was no potency-dependent effect noted, with no significant difference noted between the subgroups.

We demonstrate a potential association between topical corticosteroid use and risk of developing diabetes mellitus. This risk does not appear to be dependent on potency of the topical medication, but rather the cumulative dose and cumulative duration of use.