Related Experiment Videos
Dose-Response Association Between Systemic and Dermatologic Glucocorticoid Use and Type 2 Diabetes Mellitus: A
David Vadsholt1,2, Annika V Kvist1,2, Chano Sandiramoorthy2
1Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
Diabetes, Obesity & Metabolism
|June 16, 2026
Summary
Systemic and dermatologic glucocorticoid use increases Type 2 diabetes risk in a dose-dependent manner. Even low doses (<2.5 mg/day) showed increased odds, highlighting the need for careful prescribing and monitoring of cumulative exposure.
Area of Science:
- Endocrinology
- Pharmacology
- Public Health
Background:
- Glucocorticoids are widely used for their anti-inflammatory properties.
- Potential metabolic side effects, including an increased risk of Type 2 diabetes mellitus (T2DM), warrant investigation.
- Understanding the dose-response relationship is crucial for safe clinical practice.
Purpose of the Study:
- To examine the association between systemic and topical glucocorticoid use and the odds of developing Type 2 diabetes mellitus.
- To investigate the dose-response relationship for different routes of glucocorticoid administration.
Main Methods:
- A nationwide Danish case-control study was conducted using registry data from 2013-2021.
- Incident T2DM cases (n=149,113) aged ≥40 years were matched with controls (n=447,339).
- Glucocorticoid exposure was defined by prescription history, and dose-response was assessed using conditional logistic regression with prednisolone-equivalent doses.
Main Results:
- Higher glucocorticoid exposure and cumulative doses were observed in T2DM cases compared to controls.
- Oral systemic and dermatologic glucocorticoids showed a clear dose-dependent increase in T2DM odds, starting at doses <2.5 mg/day.
- Nasal, rectal, ophthalmic, or otic formulations did not show progressively significant associations with T2DM.
Conclusions:
- Systemic and dermatologic glucocorticoid use is associated with a dose-dependent increase in T2DM risk.
- Even low-dose glucocorticoids (<2.5 mg/day) were linked to elevated T2DM odds.
- Metabolically, other topical routes appear safe; cumulative exposure should guide prescribing and monitoring.
Related Concept Videos
01:22Diabetes 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...
01:24Type II Diabetes II: Pathophysiology
PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
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...
01:26Type II Diabetes I: Introduction
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:22Diabetes Mellitus: Overview and Type I Subtype
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...