Related Experiment Video

Updated: Jun 29, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

18.8K

Glucocorticoid-Induced Hyperglycemia: A Neglected Problem

Jung-Hwan Cho1, Sunghwan Suh1

  • 1Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Endocrinology and Metabolism (Seoul, Korea)
|March 27, 2024
PubMed

Insights

Glucocorticoid-induced hyperglycemia (GIH) affects over a third of patients and requires careful management. This review details GIH pathophysiology, risk stratification, and insulin-centered treatment strategies, including continuous glucose monitoring.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Glucocorticoids are vital therapeutics for various conditions, including COVID-19.
  • Glucocorticoid-induced hyperglycemia (GIH) affects over 33% of patients but is often overlooked.
  • Effective GIH management is crucial for improving patient outcomes.

Purpose of the Study:

  • To review current understanding and recent evidence on glucocorticoid-induced hyperglycemia (GIH).
  • To highlight the pathophysiology, risk stratification, and management of GIH.
  • To incorporate insights from the COVID-19 pandemic into GIH management strategies.

Main Methods:

  • Literature review of current understanding and latest evidence on GIH.
  • Analysis of GIH pathophysiology, including insulin resistance and beta-cell dysfunction.
  • Examination of risk stratification and insulin-centered treatment approaches for GIH.

Main Results:

  • GIH pathophysiology involves systemic insulin resistance, hepatic steatosis, obesity, and beta-cell dysfunction.
  • Risk stratification via baseline evaluation and frequent glucose monitoring is recommended for high-risk patients.
  • Insulin-centered regimens, combining basal-bolus insulin, correction doses, and continuous glucose monitoring, are ideal for managing GIH.

Conclusions:

  • Proper management of GIH is essential for patients on glucocorticoid therapy.
  • Early detection through risk stratification and monitoring is key.
  • Personalized, insulin-centered treatment strategies are vital for maintaining normoglycemia and preventing hypoglycemia.

Keywords:
Diabetes mellitusGlucocorticoidsHyperglycemia

More Related Videos

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice11:10

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice

Published on: November 16, 2011

94.4K
Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT08:13

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT

Published on: January 7, 2018

68.4K

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
257
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
196
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.3K
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
174
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
321
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
530