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Continuous Glucose Monitoring Profiles in Children Receiving High-Dose Glucocorticoid Treatment

Mari Lukka1,2, Vallo Tillmann3,4, Aleksandr Peet3,4

  • 1Department of Paediatrics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia, mari.lukka@kliinikum.ee.

Hormone Research in Paediatrics
|June 17, 2026
PubMed

Insights

Two-thirds of pediatric patients on high-dose glucocorticoids (GC) developed hyperglycemia. Continuous glucose monitoring revealed elevated glucose levels, particularly in the evening, highlighting the need for vigilant screening during GC therapy.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Glucocorticoids (GC) are primary treatments for various autoimmune and inflammatory conditions.
  • The prevalence and glycemic patterns of GC-induced hyperglycemia (GIH) in children are not well-established.
  • Current guidelines lack specific recommendations for glucose monitoring during high-dose GC therapy.

Purpose of the Study:

  • To characterize glycemic patterns in pediatric patients receiving high-dose systemic GC using continuous glucose monitoring (CGM).
  • To identify risk factors associated with glucocorticoid-induced hyperglycemia (GIH) in this population.

Main Methods:

  • Prospective observational study involving 10 pediatric patients treated with GC (≥1 mg/kg/day prednisolone-equivalent).
  • Continuous glucose monitoring (CGM) was employed during the GC treatment course.
  • Analysis included time in range (TIR), time above range (TAR), and mean sensor glucose (SG).

Main Results:

  • Seven out of ten patients (70%) experienced GIH (SG > 10 mmol/L).
  • Patients with GIH averaged 1.5 hours/day with glucose > 10 mmol/L (TAR: 6% ± 9%).
  • Peak glucose levels were observed between 16:00-23:00, irrespective of GC administration route.

Conclusions:

  • A significant proportion of pediatric patients (two-thirds) develop GIH during high-dose GC therapy.
  • Hyperglycemic episodes occurred regardless of GC administration route (oral or intravenous).
  • Evening hours show higher glucose levels, suggesting this period is critical for GIH screening.
Abstract

Keywords:
Continuous glucose monitoringGlucocorticoidGlucocorticoid-induced diabetesGlucocorticoid-induced hyperglycemiaHyperglycemia

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