Acute effect of prednisone and deflazacort on glucose tolerance in prediabetic subjects

The diabetogenic effect of deflazacort (DF), an oxazolinic synthetic corticosteroid, was studied in 12 healthy adult subjects with a positive family history of diabetes mellitus. Three oral glucose tests (oGTT) were performed at 9.00 a.m., after a 12 h fast, following randomized administration of Placebo (PL), or Deflazacort (DF 36 +36 mg) or Prednisone (PN 30 + 30 mg) 12 and 2 h before the test. Plasma glucose (BG), insulin (IRI), non-esterified fatty acids, (NEFA), total cholesterol (CL), HDL-cholesterol (HDL-CL) and triglycerides (TG) were measured at time 0, and BG, IRI, NEFA were again measured 30, 60, 90 and 120 min after oGTT. PN was followed by a significant increase in BG over the PL values in accordance with the prediabetic state of these subjects, and there was also an increase in IRI values. No change in CL, HDL-CL and TG was found. AFter DF administration, there was a small increase only in BG and IRI over PL values. The differences between DF- PL were not significant, but those between PL-PN and DF-PN were significant at p less than 0.05 (Scheffe's test). The lesser metabolic effect of DF on glucose balance by comparison with PN, as shown by these results, is consistent with previous reports of its lower osteopaenic effect. Thus, DF may be more suitable than PN and similar corticosteroids for corticosteroid therapy in prediabetic and diabetic subjects.