A systematic review of glucocorticoid use in type 1 diabetes: Glycaemic effects and clinical management strategies
Authors' conclusion
Thus, GC therapy in PWT1D destabilises glycaemic management, though impact and timing vary by formulation, dose, administration route, patient-specific factors and clinical context.
Study context
- Population
- Adults with T1D exposed to glucocorticoids, reporting glycaemic outcomes and/or management strategies
- Participants
- 368 adults22 studies
- Outcome
- Glycaemic effects of glucocorticoids
Methodological detailsPRISMA guidelines, MEDLINE, Embase and CENTRAL searched (August 2025)
- PRISMA guidelines
- MEDLINE, Embase and CENTRAL searched (August 2025)
Pooled result
As reported in the abstract
- GC exposure consistently associated with marked hyperglycaemia and increased insulin requirements
- Oral and IV GC regimens required substantial insulin dose escalation, in many cases up to 70% from baseline
- Local injectable glucocorticoids (GCs) caused delayed but prolonged excursions, requiring careful blood glucose (BG) monitoring
Further pooled results
Management strategies
- In pregnancy, antenatal corticosteroids best managed with structured SC or IV insulin protocols
- Emerging data suggest automated-insulin delivery (AID) systems attenuate BG elevation but still require user intervention
Original publication
A systematic review of glucocorticoid use in type 1 diabetes: Glycaemic effects and clinical management strategies. Diabetes Obes Metab. Published 12 January 2026. doi:10.
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