Steroid diabetes in childhood

Hyperglycemia and glycosuria are known to occur in some children receiving corticosteroids. In a retrospective study 24 such episodes were identified in 17 patients receiving steroids for a variety of primary diseases from 1968 to 1979. Detection based on symptoms averaged 26 days from initiation of steroid treatment, whereas detection based on the presence of glycosuria or hyperglycemia averaged 4.5 days. Acidosis, ketosis, and hyperglycemia (glucose level, greater than 500 mg/dL) occurred in 2, 4, and 8 patients, respectively. Insulin therapy was necessary in 15 episodes in 11 patients, but in three episodes the insulin dosage was reduced while the steroid dosage remained high. Permanent insulin dependence developed immediately in one patient and eventually in three others. Steroid-precipitated diabetes must be anticipated but should not interfere with the treatment of the primary disease.